Low Income Subsidy


Understanding Medicare Extra Help: The Low-Income Subsidy for Medicare Part D

Within the realm of Medicare prescription drug coverage (Part D), an essential initiative called Extra Help stands ready to provide vital assistance to individuals with limited income and resources. Also known as the Part D Low-Income Subsidy (LIS), Extra Help offers support in covering premiums, deductibles, and copayments linked to a Medicare prescription drug plan.

Valued at approximately $5,300 per year, Extra Help represents a significant lifeline. This section delves into eligibility criteria, benefits, and the application process for this pivotal program.

Qualifying for Medicare Extra Help: A Closer Look

To be eligible for Extra Help, certain criteria must be met:

In most cases, your income and resources must fall below a specified threshold to qualify for Extra Help. The limits for 2023 are:

Your Situation

Income Limit

Resource Limit




Married Couple Living Together



Income pertains to your total earnings within a calendar year, encompassing both individual and spousal income if applicable. Resources encompass the cumulative value of your assets, including:

Benefits of a Low Income Subsidy

The scope of Extra Help encompasses two tiers: full and partial. Here’s an in-depth exploration of the benefits each tier offers:

Full Extra Help Benefits: Comprehensive Assistance

Full Extra Help caters to individuals covered by Medicare who also meet their state’s Medicaid criteria. The benefits comprise:

Once your aggregate drug expenses (inclusive of both personal and plan contributions) reach $7,400, the cost for each covered drug is reduced to $0. If you hold full Medicaid coverage and are part of the Qualified Medicare Beneficiary (QMB) program, the maximum payment for each covered drug is capped at $4.30.

Partial Extra Help Benefits: Tailored Assistance

Partial Extra Help caters to individuals with slightly higher incomes. The benefits encompass:

Upon reaching a cumulative drug expense of $7,400, the payment for generic drugs becomes $4.15, while brand-name drugs are capped at $10.35.

Exploring Additional Perks of Extra Help

Beyond alleviating out-of-pocket costs, Extra Help offers:

Navigating the Extra Help Application Process

Eligibility for Extra Help can either be automatic or require an application. Automatic qualification applies to those who:

If automatic eligibility doesn’t apply, you can apply through the Social Security Administration via three channels:

  • Online—Visit the Social Security Administration’s website
  • Phone—Dial 800-772-1213 (TTY: 800-325-0778)
  • In person—Visit your local Social Security office

Note: If you presently don’t meet the criteria for Extra Help, you can reapply whenever your income and resources undergo changes.

A Modest Investment with Profound Impact

The assistance offered by Extra Help extends to covering a significant portion or even the entirety of your monthly Medicare premiums, annual deductibles, and prescription copayments. For further avenues to mitigate out-of-pocket expenses, consider exploring additional Medicare Savings Programs.

For any inquiries or assistance regarding Medicare Extra Help, feel free to reach out to our team of experts.

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