Medicare Part D prescription drug coverage can be expensive, especially for beneficiaries on fixed incomes with significant medication needs. The federal government offers a program called Extra Help (also known as the Low Income Subsidy, or LIS) that can dramatically reduce your Part D costs — and millions of people who qualify are not enrolled.
What Is Extra Help?
Extra Help is a Social Security Administration (SSA) program that helps people with limited income and resources pay for Medicare Part D costs. Depending on your income and assets, Extra Help can help cover:
- Part D premiums
- The Part D deductible
- Prescription drug copays and coinsurance
In 2025, full Extra Help beneficiaries pay no more than a few dollars per prescription for covered drugs — typically $4.90 for generics and $12.15 for brand-name drugs.
Who Qualifies?
To qualify for Extra Help in 2025, your income must generally be at or below 150% of the Federal Poverty Level (FPL), and your assets (excluding your home, car, and certain other items) must be below a set limit.
- Income: Approximately $22,590/year for individuals or $30,660/year for married couples (2025 figures)
- Assets: Approximately $17,220 for individuals or $34,360 for married couples
These thresholds are updated each year. Beneficiaries who receive Medicaid or Supplemental Security Income (SSI) are automatically eligible for Extra Help.
Full vs. Partial Extra Help
Extra Help comes in different levels:
- Full Extra Help: Covers most or all of your Part D premium (up to the benchmark), eliminates the deductible, and caps copays at a very low amount.
- Partial Extra Help: Reduces but doesn't eliminate your Part D costs. You may still pay a reduced premium and deductible.
How to Apply
You can apply for Extra Help through:
- The Social Security Administration website (ssa.gov)
- By calling SSA at 1-800-772-1213
- At your local Social Security office
- Through your State Medicaid office (which may also determine eligibility for state-level assistance programs)
Extra Help and Your Plan Choice
If you receive Extra Help, you are also eligible for a Special Enrollment Period every quarter, which means you can switch Part D plans more frequently than other beneficiaries. This gives you additional flexibility to optimize your drug coverage throughout the year.
If you think you or a family member might qualify for Extra Help — even if you're not sure — it's worth applying. Denial costs you nothing. Approval could save you thousands of dollars per year. Call us at (530) 395-5309 and we'll help you understand your options and navigate the application.