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Are there any Medicare Part D prescription drug plans that are free for Medicare beneficiaries who receive Medicaid or Extra Help?

Category: Medicaid, LIS, & Extra Help
Updated: Apr 09, 2025
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No for most Extra Help recipients.  In most cases, there are no Medicare Part D plans that are totally "free" to low-income Medicare beneficiaries, but there are plans with a $0 (or low) monthly premium, no deductible, and very low drug costs.

If you receive Medicare Part D Extra-Help (or the Low-Income Subsidy (LIS)), then you will find that your state has several Medicare Part D plans that qualify for the $0 monthly premium.  To see the Medicare Part D plans in your home state that qualify for the $0 monthly premium, you can use our PDP-Finder.  The following is a link to an example for South Carolina: PDP-Finder.com/SC/LIS

Also, people who qualify for the Low-Income Subsidy will have their formulary medications covered by their Medicare Part D plan at a very low price.  For example, the copayment is $1.60 for generic medications and for brand-name medications $4.80 in 2025 for people at or below 100% FPL. Beneficiaries at or below 150% FPL pay $4.90 in 2025 for generics and $12.15 for brand-name medication.

Only full-benefit dual-eligible for both Medicare and Medicaid Medicare beneficiaries (FBDE), who are institutionalized or receive Home and Community-Based Services equivalent to institutionalized, would have a $0 copayment for their formulary medications. 

Here is link to the 2025 Medicare Part D plan parameters and Extra Help limits (at the bottom of the table): Q1Medicare.com/2025#chart.


In 2026, the copayment is $1.60 for generic medications and for brand-name medications $4.90 for people at or below 100% FPL. Beneficiaries at or below 150% FPL pay $5.10 in 2026 for generics and $12.65 for brand-name medication.  See Q1Medicare.com/2026#chart.

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 150% of FPL and consequently, the pre-2024 "partial" Extra Help (135% to 150% of FPL) designation was eliminated.

Please note that the financial limits that define the different levels of the Extra-Help program will change every year.

To apply for the Extra-Help program, contact your local Medicaid office or the Social Security Administration at: 1-800-772-1213.


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