Prescription drug costs can add up quickly, even if you already have a Medicare Part D plan. Extra Help is a federal program designed to lower those costs for people with limited income and resources, often saving them hundreds or more each year on medications.
Extra Help (also called the Low-Income Subsidy, or LIS) is a Medicare program that helps pay for:
If you qualify, you keep your Medicare drug coverage through a Part D plan, but your share of the costs is reduced under the Extra Help rules.
You automatically qualify and do not need a separate application if you:
If you fall into one of these groups, you should receive a notice in the mail about Extra Help and how it applies to your coverage.
Others can still get Extra Help based on income and resources. The limits change periodically, but generally the program is for people with low to moderate income and limited savings.
Resources usually include:
They generally do not include your home, one car, household items, or a burial plot. Because the exact limits and details change, it’s important to check current guidelines or talk with Social Security or your State Health Insurance Assistance Program.
If you’re not automatically enrolled, you can apply:
You can apply any time of year. If you qualify, Extra Help usually begins as soon as your application is processed and can be applied to your current Part D plan.
With Extra Help, your monthly premium may be reduced or fully covered for certain plans, and your copays at the pharmacy are capped at lower amounts than standard Part D cost-sharing. You also avoid or greatly reduce:
If your income or resources change, your Extra Help level may change, but in many cases you’ll be reviewed automatically.
Understanding Extra Help is important if you ever skip medications because of cost. If your income and savings are limited, applying is often worth it—even if you’re not sure you’ll qualify—because the potential savings on prescriptions can be significant.