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Medicare Extra Help: Lowering Your Prescription Drug Costs
Extra Help is a federal program that can significantly lower what you pay for Medicare prescription drug coverage -- and some people qualify for it automatically without ever applying.
Extra Help, formally the Part D Low-Income Subsidy, is a federal program administered by Social Security that helps pay Medicare drug plan costs -- premium, deductible, and copays -- for people with limited income and resources. Whether you qualify depends on your specific numbers, but the potential savings are significant enough that it's worth checking rather than assuming it doesn't apply.
It's based on income and resources, both with annual limits
Social Security sets both an income limit and a separate resource (asset) limit each year, and both matter -- resources generally means savings, investments, and similar assets, not counting your home or vehicle. The exact current-year numbers are what determine eligibility, not a rule of thumb.
Some people qualify automatically, with no application needed
If you already have Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program, Social Security generally enrolls you in Extra Help automatically -- you may already have it without realizing it.
- Check a recent Medicare drug plan statement for any mention of Extra Help or LIS
- Automatic enrollment doesn't require you to have applied yourself
It lowers your Part D costs specifically
Extra Help reduces or eliminates your Medicare drug plan's premium and deductible, and caps what you pay per prescription -- whether you have a standalone Part D plan or a Medicare Advantage plan that includes drug coverage (MAPD).
It's different from -- but connected to -- Medicare Savings Programs
Extra Help only covers drug costs. Medicare Savings Programs (QMB, SLMB, QI) can additionally help with Part A and Part B costs, and automatically qualify you for Extra Help too -- worth checking both if cost is a concern.
Your next step
See your real Medicare timing, then talk to a licensed agent about cost-assistance programs like Extra Help.
Common questions
How do I apply for Medicare Extra Help?
You can apply through Social Security (ssa.gov or by phone) or your state Medicaid office. If you already have Medicaid, SSI, or a Medicare Savings Program, you're generally enrolled automatically and don't need to apply separately.
Does Extra Help cover my Part B premium too?
No -- Extra Help specifically lowers Part D (prescription drug) costs. If you need help with Part A or Part B premiums and cost-sharing too, a Medicare Savings Program is the separate program that covers that.
What if my income is a little too high?
Eligibility depends on the current year's exact income and resource limits, not a rough estimate -- it's worth checking your specific numbers rather than assuming you don't qualify, since the limits and what counts as a resource are more specific than most people expect.
Questions are easier by phone.
Call 855-367-1095 to talk through your situation with licensed insurance help.
- Licensed insurance help
- No guaranteed eligibility, pricing, or availability
- Educational starting point
GetFastRates.com is not connected with or endorsed by the U.S. government or the federal Medicare program. Calling connects you with licensed insurance help. Plan availability, costs, benefits, and enrollment rules can vary by state, carrier, and individual situation.