The Medicare Part D Extra Help or Low-Income Subsidy (LIS) program helps people with limited financial resources pay for their Medicare Part D prescription drug coverage.

If you receive Medicare Part D Extra Help, you may pay a lower - or $0 monthly premium, a $0 initial deductible, have continuous coverage even through the Donut Hole or Coverage Gap, and pay very little for your prescription drugs that are covered by your Medicare Part D plan.

Extra Help eligibility is based on the income you earn and the financial resources you own - and the financial limits can change every year.

For example, in 2024 and early-2025, you will qualify for at Extra Help if your income is below $22,590 per year for a single person (or $30,660 for a married couple living together or even more if you have dependent children or grandchildren living with you), AND if your assets are below $17,220* for a single person (or $34,360* if you are married).  *includes the $1,500 burial allowance.

The following items are NOT included in the income calculation:

• Housing assistance,
• Medical treatment and drugs,
• Food stamp assistance, etc.

The following items are included in resources (or assets):

• bank accounts,
• stocks and bonds,
• Real estate (other than your primary residence), etc.

The following items are NOT included in resources:

• the house you live in,
• your car,
• other personal possessions such as your furniture and jewelry, etc

Medicaid and Extra Help

If you qualify for your state's Medicaid program, you automatically qualify for the Medicare Part D "Extra Help" program that may lower the cost of your prescription drugs.  And if you are qualified for Medicaid and are automatically qualified for Extra Help, Medicare will mail you a letter about your Extra Help.  If you get one of these letters, keep it for your records.

You still need to join a Medicare Part D drug plan (PDP) or Medicare Advantage plan (MAPD) to get Medicare prescription drug coverage.

You may be automatically enrolled into a Medicare Part D plan

If you do not join a Medicare Part D drug plan, Medicare may enroll you in a plan to make sure you have drug coverage.  If Medicare enrolls you in a plan, Medicare will send you a letter explaining when your coverage begins.

If you want to choose your own Medicare Part D plan or do not want to join a Medicare Part D drug plan (for example, because you want to keep your employer or union coverage instead), you can call 1-800-MEDICARE (1-800-633-4227) or the plan listed in your letter and tell a Medicare representative you do not want to be in the Part D plan - or you would like to choose your own Medicare Part D plan coverage rather then the plan selected automatically.

Remember: you must be in a Medicare Part D drug plan (PDP or MAPD) to take advantage of the Extra Help program.

A bit of history about "Partial" Extra Help

Keep in mind that 2023 was the last year for partial-Extra Help.  For plan year 2024 and beyond, the Inflation Reduction Act (IRA) increased full-Extra Help benefits to people at or below 150% of FPL and consequently, the partial-Extra Help (135% to 150% of FPL) designation was eliminated.


Question:  Is there any difference between Extra Help and the Low-Income Subsidy?

No,  . . . and you can click here to read more about Extra Help and the LIS . . .