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, 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 2026 and early-2027, you will qualify for at Extra Help if your income is below $23,940 per year for a single person (or $32,460 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 $18,090* for a single person (or $36,100* if you are married). *includes the $1,500 per person burial allowance.
The following items are NOT included in the income calculation:
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...
If you receive Medicare Part D Extra Help, you may pay a lower - or $0 monthly premium, a $0 initial deductible, 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 2026 and early-2027, you will qualify for at Extra Help if your income is below $23,940 per year for a single person (or $32,460 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 $18,090* for a single person (or $36,100* if you are married). *includes the $1,500 per person burial allowance.
The following items are NOT included in the income calculation:
- Housing assistance,
- Medical treatment and drugs,
- Food stamp assistance, etc.
- bank accounts,
- stocks and bonds,
- Real estate (other than your primary residence), etc.
- the house you live in,
- your car,
- other personal possessions such as your furniture and jewelry, etc
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...
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