Medicare Extra Help (LIS): Reduce Your Drug Costs Significantly

# Medicare Extra Help (LIS): Reduce Your Drug Costs Significantly

Medicare Extra Help, also called the Low Income Subsidy (LIS), helps Medicare beneficiaries with limited income and resources pay for prescription drugs. This program can save qualifying individuals up to $5,000 or more per year on drug costs.

!Hands offering financial help, representing Medicare Extra Help and savings programs

What Extra Help Covers

> Most beneficiaries pay the standard $202.90 monthly Part B premium in 2026 — but Extra Help and Medicare Savings Programs can lower Part B and Part D costs for those who qualify. (Source: CMS, 2026 Part B premium.)

If you qualify for Extra Help, Medicare pays for:

Premium Assistance

• Part of or all of your Part D monthly premium
• Amount depends on your income level

Deductible Elimination

• No annual Part D deductible
• Full Extra Help eliminates it completely

Reduced Copays

• Generic drugs: $0 - $4.50
• Brand-name drugs: $0 - $11.20
• Amount depends on level of Extra Help

No Coverage Gap

• Extra Help eliminates the donut hole
• Low copays continue throughout the year

Who Qualifies for Extra Help?

Income Limits (2025)

• Individual: Up to approximately $22,590/year
• Married couple: Up to approximately $30,660/year

Resource Limits (2025)

• Individual: Up to $17,220
• Married couple: Up to $34,360

Note: These limits change annually and may vary. Some resources don't count.

Resources That Don't Count:

• Your home
• One car
• Burial plots for you and immediate family
• Up to $1,500 per person for burial expenses
• Personal possessions
• Life insurance policies

Levels of Extra Help

Full Extra Help

For those with the lowest income and resources:

• $0 monthly premium (for benchmark plans)
• $0 deductible
• Copays: $0 for full dual-eligibles, up to $4.50 generic / $11.20 brand for others

Partial Extra Help

For those with slightly higher income/resources:

• Sliding scale premium assistance
• Reduced deductible
• 15% coinsurance after deductible

How to Apply for Extra Help

Option 1: Social Security Administration

• Apply online at ssa.gov/extrahelp
• Call 1-800-772-1213
• Visit your local Social Security office

Option 2: State Medicaid Office

• Apply through your state Medicaid program
• May automatically qualify you for Extra Help

Option 3: Medicare Advisor Assistance

• We can help you complete the application
• Ensure you include all relevant information

Documentation Needed

Have this information ready when applying:

• Your Medicare number
• Income information (Social Security, pensions, wages)
• Bank account balances
• Stocks, bonds, and investment values
• Life insurance policy details
• Real estate owned (besides your home)

Automatic Qualification

You automatically qualify for Extra Help if you have:

• Full Medicaid coverage
• Supplemental Security Income (SSI)
• Medicare Savings Program enrollment (QMB, SLMB, QI)

If you auto-qualify: You don't need to apply—you'll be enrolled automatically.

Extra Help and Plan Selection

Benchmark Plans

• "Benchmark" Part D plans charge $0 premium to Extra Help recipients
• Available plans vary by county and year

Non-Benchmark Plans

• You can choose any Part D plan
• May pay the difference between your plan premium and benchmark amount

Medicare Advantage with Part D

• Extra Help applies to MA-PD plans too
• May still owe MA premium (separate from drug coverage)

Extra Help Benefits Beyond Part D

Qualifying for Extra Help also:

• Provides a Special Enrollment Period to change plans
• Allows quarterly plan changes (January-September)
• May indicate eligibility for other programs

Related Programs to Know

Medicare Savings Programs (MSPs)

Pay your Part B premium (and sometimes more):

• QMB - Pays Part A & B premiums, deductibles, coinsurance
• SLMB - Pays Part B premium
• QI - Pays Part B premium

State Pharmaceutical Assistance Programs (SPAPs)

Some states offer additional drug cost help beyond Extra Help.

Common Questions

Q: Will Extra Help affect my other benefits? A: Extra Help is not counted as income for other federal programs.

Q: How long does approval take? A: Typically 2-4 weeks after application submission.

Q: Can I reapply if denied? A: Yes, especially if your circumstances change.

Q: Does Extra Help cover all my drugs? A: It covers Part D drugs. Some drugs may not be covered by any Part D plan.

Get Help Applying

Our advisors help Florida residents determine Extra Help eligibility and navigate the application process. We'll also help you choose the best Part D plan to maximize your savings.

Schedule Your Free Consultation

Next steps: Take our 2-minute Medicare plan quiz, book a free Medicare review, or see our Extra Help guide.

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.