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Can I still apply for the Medicare Part D Extra Help program even though I am already enrolled in a Medicare Part D plan?

Category: Medicaid, LIS, & Extra Help
Updated: Apr, 20 2024


Yes. You can apply for the Medicare Part D financial Extra Help program (or Low-Income Subsidy) at any time throughout the plan year - even when you are already enrolled in a Medicare Part D plan.

Question:  What is Extra Help?

As a reminder, the Medicare Part D Extra-Help or Low-Income Subsidy (LIS) program helps pay your monthly Medicare prescription drug plan premiums, deductible, and prescription drug costs.

Question:  How do I qualify for Medicare Part D Extra Help?

If you are qualified for your state's Medicaid program, you are automatically qualified for Medicare Part D Extra Help.

If you are not currently Medicare / Medicaid eligible (dual eligible), then your income and assets - as measured against the annual Federal Poverty Level (FPL) Guidelines - will be used to determine whether you are eligible for the Medicare Part D Extra-Help program.


Question:  How do I apply for Extra Help?

You can contact or visit your local state Medicaid office or call the Social Security Administration (1-800-772-1213) (or visit a local Social Security office) to get more information about qualifying and enrolling into the Extra-Help program.

Here is a link provided by Medicare that should help you find your state Medicaid office: https://www.medicare.gov/talk-to-someone

Extra Help and a Special Enrollment Period

If you are eligible for the Medicare Part D Extra Help program, you will be granted a Special Enrollment Period (SEP) allowing you one opportunity per quarter (every 3 months) to change Medicare plans during the first 9 months of the year.  So, if you find that your Medicare Part D or Medicare Advantage plan coverage is not adequate, you have the option to change to another Medicare Part D or Medicare Advantage plan that provides more affordable health and prescription coverage.


Not sure where to start?

You can call a Medicare representative toll-free at 1-800-633-4227 to learn more about the Medicare Part D Extra Help program.

You can click on the following link to learn more about the Extra Help program:
q1medicare.com/PartD-Financial-Assistance-by-Medicaid.php.

You can also review our recent articles on the Extra Help or Low-Income Subsidy and see information on the annual Federal Poverty Level (2024/2025 FPL) guidelines that define the level of Extra Help: Q1News.com/C/8





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  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
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  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
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  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.