Prescription costs are one of the biggest worries I hear about. Many people don’t know that Medicare has a program designed to lower them: Extra Help, also called the Low-Income Subsidy (LIS).
What Extra Help does
Extra Help lowers what you pay for Medicare prescription drug coverage (Part D), including:
- Monthly Part D plan premiums (often reducing them to $0 for certain plans)
- The yearly Part D deductible
- Copays for covered prescriptions
It can also protect you from the Part D late enrollment penalty.
Who gets it automatically
You automatically qualify for Extra Help if you have Medicare and also have:
- Full Medi-Cal (Medicaid) coverage
- Supplemental Security Income (SSI)
- Help from a Medicare Savings Program, which pays Part B premiums for people with limited income
If you’re automatically eligible, Medicare sends you a letter, usually on purple paper.
Who else may qualify
If you don’t qualify automatically, you may still qualify based on your income and resources. The limits change every year, so don’t rule yourself out. If money is tight, it’s worth applying.
How to apply
Apply through Social Security online at ssa.gov/extrahelp, by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778), or at your local Social Security office. There’s no cost to apply.
Extra Help gives you more flexibility
People with Extra Help generally have more opportunities to change their drug coverage during the year than other Medicare members. If your current plan isn’t working for you, ask about your options.
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This article is for general educational purposes and is not a recommendation of any specific plan. Plan availability, benefits, and costs vary by plan and county and may change each year. For complete information, contact Medicare.gov or 1-800-MEDICARE.