Dear Marci,
I have Medicare Part D, and my doctor recently prescribed me a few new medications that I’m struggling to afford. I heard that the Extra Help program can help pay for Part D costs. What is Extra help and how do I know if I’m eligible for it?
Deepa (Warba, MN)
Dear Deepa,
You are correct! Extra Help, also called the Low-Income Subsidy (LIS), is a program that lowers Part D costs—both premiums and out-of-pocket expenses. Your income and assets (meaning your savings and other resources) determine if you’re eligible for Extra Help. Keep reading for a more detailed explanation of the benefits of Extra Help and its eligibility criteria.
What is Extra Help?
Extra Help is a federal program that lowers premiums and helps pay for out-of-pocket costs associated with Medicare prescription drug coverage. The Extra Help program:
- Pays your Part D premium for a basic Part D plan up to a state-specific benchmark amount.
- Lower your costs for prescription drugs by eliminating the deductible period and capping coinsurance and copays.
- Allows you more flexibility to change your Part D plan during the year through a Special Enrollment Period.
- Eliminates the Part D late enrollment period (LEP), if you have one.
Extra Help Eligibility
- In 2025, you may be eligible for Extra Help if your monthly income is up to $1,976 ($2,664 for couples) and your assets are below $17,600 ($35,130 for couples). See the Extra Help income and asset limit chart for details.
- Even if your income or assets are above the eligibility limits, you could still qualify for Extra Help because certain types of income and some assets are not counted.
- If you have Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program (MSP), you automatically qualify for Extra Help regardless of whether you meet Extra Help’s income and asset eligibility requirements.
Keep in mind that Extra Help is not a replacement for Part D or a plan on its own. Extra Help works with your plan by reducing your costs. You must still have a Part D plan to have Medicare prescription drug coverage.
Hope this helps!
-Marci
Am I eligible for Extra Help?
March 10, 2025