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Am I eligible for Extra Help? *ONLINE ONLY*

March 2025

By Medicare Rights Center

I have Medicare Part D, and my doctor recently prescribed me a few new medications that I’m struggling to afford. I heard that the Extra Help program can help pay for Part D costs. What is Extra help and how do I know if I’m eligible for it? -Deepa (Warba, MN)

Dear Deepa,

You are correct! Extra Help, also called the Low-Income Subsidy (LIS), is a program that lowers Part D costs—both premiums and out-of-pocket expenses. Your income and assets (meaning your savings and other resources) determine if you’re eligible for Extra Help. Keep reading for a more detailed explanation of the benefits of Extra Help and its eligibility criteria.

What is Extra Help?

Extra Help is a federal program that lowers premiums and helps pay for out-of-pocket costs associated with Medicare prescription drug coverage. The Extra Help program:

• Pays your Part D premium for a basic Part D plan up to a state-specific benchmark amount.

• Lower your costs for prescription drugs by eliminating the deductible period and capping coinsurance and copays.

• Allows you more flexibility to change your Part D plan during the year through a Special Enrollment Period.

• Eliminates the Part D late enrollment period (LEP), if you have one.

Extra Help Eligibility

• In 2025, you may be eligible for Extra Help if your monthly income is up to $1,976 ($2,664 for couples) and your assets are below $17,600 ($35,130 for couples). See the Extra Help income and asset limit chart for details.

o Even if your income or assets are above the eligibility limits, you could still qualify for Extra Help because certain types of income and some assets are not counted.

• If you have Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program (MSP), you automatically qualify for Extra Help regardless of whether you meet Extra Help’s income and asset eligibility requirements.

Keep in mind that Extra Help is not a replacement for Part D or a plan on its own. Extra Help works with your plan by reducing your costs. You must still have a Part D plan to have Medicare prescription drug coverage.

Hope this helps!

-Marci

The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs and public policy initiatives.