Medicare Part D Extra Help Program

If you are enrolled in Medicare and you have a low income, you can apply to the Medicare Part D Extra Help program. Extra Help is the name of a Medicare program that can help you pay for all or part of your premiums, all or part of your annual deductible, and lower the co-pays on your prescriptions. It is also called the Medicare Low Income Subsidy (LIS).

Starting January 1, 2024, anyone who qualifies for Extra Help gets a full subsidy. Partial subsidies are gone now. A full subsidy pays for most of your costs.

You may qualify for the full Extra Help Program if your yearly income and resources are below these limits:

• Single person: Income less than $21,870 and resources less than $16,600 in 2023. 
   
• Married person living with a spouse and no other dependents: Income less than $29,580 and resources less than $33,240 in 2023. 

If you are below the limit for only one of the factors (income or resources), you can’t get full help, but you might be able to get some help. You should still apply.

Note: a deductible is the amount you have to pay out of pocket before your Medicare Part D prescription drug plan steps in and helps out.

With a Full Subsidy you get:

• Extra Help pays for premiums (your plan’s premiums must be lower than the “benchmark” premium which is $39.87 per month in 2023)
• you do not have a deductible
• your prescription co-pays are no more than $4.15 for generic drugs or $10.35 for each brand name covered drug 
• there is no coverage gap

Some people automatically get Extra Help. If you are on Medicare Part D now and are in one of the following groups, you should already be signed up for the Extra Help program:

• Dual Eligibles. This means that you get Medicare Part A and/or Part B and you also get some Medical Assistance.

• On a Medicare Savings Program (QMB, SLMB, QI). See our fact sheet Medicare Savings Programs.

• Getting SSI

If you are in 1 of these groups and are NOT getting Extra Help, contact the Social Security Administration and apply right away.

You can also get Extra Help if you are on Medicare Part D now and meet the income eligibility rules.

You can apply for Extra Help any time. Apply through the Social Security Administration or the State Medicaid office.  

You can apply by phone or have an application mailed to you.

Call: 1-800-772-1213

TTY 1-800-325-0778

To apply online go to: ssa.gov/extrahelp/