Prescription drug costs can be one of the biggest financial burdens for Medicare beneficiaries. If you live on a limited income, the Extra Help program — also known as the Low-Income Subsidy (LIS) — can dramatically reduce what you pay for Part D premiums, deductibles, and copayments. Millions of people qualify but never apply, often because they don't realize the benefit exists or assume they won't meet the requirements.
What Is Extra Help?
Extra Help is a federal assistance program administered by the Social Security Administration (SSA) that helps Medicare beneficiaries with limited income and resources pay for prescription drug coverage under Medicare Part D. The program can save you an average of several thousand dollars per year on medication costs.
When you qualify for Extra Help, the government picks up a significant portion of your Part D expenses, including:
- Monthly premiums for your Part D plan
- Annual deductibles
- Copayments or coinsurance for each prescription you fill
The exact amount of assistance depends on whether you receive the full subsidy or a partial subsidy, which is determined by your income and asset levels.
Full Subsidy vs. Partial Subsidy
Not everyone who qualifies for Extra Help receives the same level of support. The program has two tiers, and where you fall depends on your financial situation.
Full Subsidy
You may receive the full Extra Help benefit if your annual income and countable resources fall below certain thresholds. With the full subsidy, you can expect:
- No monthly premium (as long as you choose a plan at or below the benchmark amount)
- No annual deductible
- Minimal copayments — typically a few dollars per generic prescription and slightly more for brand-name drugs
Partial Subsidy
If your income and resources are somewhat higher but still within program limits, you may receive a partial subsidy. Under partial Extra Help:
- You pay a reduced monthly premium (roughly 25% to 75% of the plan's full premium, depending on your income)
- You face a reduced deductible
- You pay 15% coinsurance on covered drugs until you reach the catastrophic coverage threshold
Even the partial subsidy can save you hundreds or thousands of dollars each year, so it is well worth applying if you think you might be close to the income limits.
Who Is Eligible?
Eligibility for Extra Help is based on two main factors: income and resources. The specific dollar thresholds are updated annually, so it is important to check the latest figures each year. In general terms:
- Income limits are set at a percentage of the federal poverty level (FPL). For the full subsidy, your income typically needs to fall below 135% of the FPL. For the partial subsidy, income limits extend up to 150% of the FPL.
- Resource limits consider assets such as bank accounts, stocks, bonds, and certain other holdings. Your primary home, personal belongings, vehicles, life insurance policies, and burial plots are usually not counted as resources.
Keep in mind that these thresholds apply to individuals and married couples differently, with higher limits for couples.
Automatic Eligibility for Dual-Eligible Beneficiaries
Certain groups of people are automatically enrolled in Extra Help without needing to fill out an application. You are deemed automatically eligible if you:
- Receive full Medicaid benefits (dual-eligible for both Medicare and Medicaid)
- Qualify for the Medicare Savings Program (QMB, SLMB, or QI)
- Receive Supplemental Security Income (SSI)
If you fall into one of these categories, you should receive a notice letting you know that you qualify. You will still need to enroll in a Part D plan to use the benefit, but the Extra Help subsidy will be applied automatically once you do.
How Extra Help Reduces Your Part D Costs
To understand the real impact of Extra Help, consider what Part D costs look like without it. A standard Part D plan in 2026 may charge:
- A monthly premium that varies by plan
- An annual deductible of up to $615 before coverage kicks in
- 25% coinsurance during the initial coverage phase
- Out-of-pocket costs up to the $2,100 annual cap, after which you pay $0 for covered drugs
With Extra Help, most or all of these costs shrink significantly. Full-subsidy recipients effectively skip the deductible and coverage gap entirely, paying only small, fixed copays. Partial-subsidy recipients still benefit from meaningful reductions at every stage of the Part D benefit structure.
How to Apply Through the Social Security Administration
Applying for Extra Help is straightforward, and you have several options:
- Online: Visit the SSA website and complete the application electronically. The online form takes roughly 15 to 20 minutes.
- By phone: Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to request an application or apply over the phone with the help of a representative.
- In person: Visit your local Social Security office to apply with assistance from staff.
- By mail: Download and print the application form (SSA-1020), fill it out, and mail it to your local Social Security office.
When you apply, you will need to provide information about your income, savings, investments, and real estate (other than your home). The process does not require extensive documentation upfront — SSA will verify the information you provide.
What Happens After You Apply
After submitting your application, SSA will review your financial information and send you a decision letter, usually within a few weeks. If you are approved:
- You can choose a Part D plan that works with your Extra Help benefit
- If you do not pick a plan, Medicare may assign you to one automatically
- You have the right to switch Part D plans once per quarter during the first three quarters of the year, giving you more flexibility than standard beneficiaries
If your application is denied, you can appeal the decision or reapply if your financial circumstances change.
Getting Help with Your Application
If the application process feels overwhelming, free assistance is available. Your State Health Insurance Assistance Program (SHIP) provides one-on-one counseling to help you understand your options and complete the paperwork. You can also reach out to local Area Agencies on Aging or nonprofit organizations that specialize in Medicare guidance.
Key Takeaways
- Extra Help can save qualifying beneficiaries thousands of dollars per year on prescription drug costs
- Both full and partial subsidies provide meaningful financial relief
- Dual-eligible individuals and SSI recipients are automatically enrolled
- Applying through SSA is free, simple, and can be done online, by phone, or in person
- Free counseling through SHIP is available if you need guidance
If you are on a fixed income and struggling to afford your medications, Extra Help is one of the most valuable Medicare benefits available. Taking a few minutes to apply could make a significant difference in your monthly budget. You may also qualify for Medicare Savings Programs that help cover your Part B premiums and other costs.