Do You Qualify for Extra Help with Part D?
Extra Help is a federal program that can wipe out most of your Medicare prescription drug costs. About 2.4 million people who qualify aren't getting it. Answer 5 quick questions to see if you likely qualify — and how to apply for free.
The Short Answer
Extra Help (the Low-Income Subsidy) lowers or eliminates your Part D premium, deductible, and copays — and waives the Part D late penalty. If you're already on Medicaid, SSI, or a Medicare Savings Program, you automatically qualify. Otherwise it comes down to your income and countable resources. Since January 2024 there's just one full benefit — the old "partial" tier is gone. Applying is free, and you apply directly with Social Security.
Important: This information is for general educational purposes only and is not a substitute for personalized Medicare counseling. Enrollment rules have many exceptions. Contact a licensed Medicare counselor or your State Health Insurance Assistance Program (SHIP) before making enrollment decisions. Find your local SHIP at shiphelp.org or call 1-800-MEDICARE (1-800-633-4227).
Editor's Recommendation
If you're close, apply anyway — the exclusions are generous
The biggest reason eligible people miss out on Extra Help is that they assume they have too much in savings. But your home, one car, and household goods don't count, and Social Security applies income disregards on top of the limits. If you're anywhere near the numbers, apply — it's free and there's no downside.
A free SHIP counselor can sit with you, check your specific situation, and help you complete the application. This is exactly what SHIP is for — no cost — they do not sell anything.
National SHIP directory: shiphelp.org · Social Security: 1-800-772-1213
What is Extra Help?
Extra Help — officially the Low-Income Subsidy, or LIS — is a federal program that lowers what you pay for Medicare Part D prescription drug coverage. It can eliminate your Part D premium (up to the benchmark amount), remove your deductible, cap your copays at low fixed amounts, and waive the Part D late enrollment penalty. For someone with ongoing prescriptions, it can save thousands of dollars a year.
One benefit, not two, since 2024
You may have read about "full" and "partial" Extra Help. That distinction no longer exists. Effective January 1, 2024, the Inflation Reduction Act combined them into a single, unified full benefit for everyone who qualifies at or below 150% of the Federal Poverty Level. About 300,000 people who had partial Extra Help were automatically moved up to the full benefit.
Who automatically qualifies
If you already have Medicaid, SSI, or a Medicare Savings Program (QMB, SLMB, or QI), you automatically qualify for full Extra Help — no separate application needed. If you have one of these and your Part D plan isn't showing the reduced costs, contact Social Security, because you may not be getting a benefit you're entitled to.
What counts — and what doesn't
Two things decide eligibility if you don't automatically qualify: your income and your countable resources. Income includes Social Security, pensions, wages, interest, and dividends. Countable resources include money in checking and savings, stocks, and bonds. What does not count is just as important: your home, one vehicle, personal belongings, household goods, and burial funds up to $1,500 per person. Because so much is excluded, people who think they have too much often qualify anyway.
How to apply — for free
You apply directly with Social Security, online at ssa.gov or by phone at 1-800-772-1213. A free SHIP counselor can help you complete it. Applying is free and there's no penalty for applying if you don't qualify. If your income is a little too high for Extra Help, ask about the Medicare Savings Programs — they use different limits, and qualifying for one automatically gives you full Extra Help.
Frequently Asked Questions About Extra Help
Extra Help — also called the Low-Income Subsidy or LIS — is a federal program that lowers Medicare Part D prescription drug costs. It covers most or all of your Part D premium and deductible, gives you low fixed copays, and waives the Part D late enrollment penalty. To qualify, your income must generally be at or below 150% of the Federal Poverty Level and your resources within the federal limit.
No. Effective January 1, 2024, the Inflation Reduction Act eliminated the partial Extra Help tier. There is now a single, unified full benefit for everyone who qualifies at or below 150% of the Federal Poverty Level. If you used to receive partial Extra Help, you were automatically moved to the full benefit.
Countable resources include money in checking and savings accounts, stocks, bonds, and other investments. Your home, one vehicle, personal belongings, household goods, and burial funds up to $1,500 per person do NOT count. Because so much is excluded, many people who assume they have too much actually qualify — so it is worth applying.
No. Applying is free, and there is no penalty for applying even if you do not qualify. You apply directly through Social Security at ssa.gov or 1-800-772-1213, or with free help from a SHIP counselor. You never need to pay anyone to apply for Extra Help.