How to Get Extra Help With Medicare Part D Costs

Are Your Prescription Costs Eating Into Your Budget?

If you’re spending hundreds — or even thousands — of dollars each year on prescription medications, you’re not alone. Nearly one in four seniors reports difficulty affording their prescriptions, according to the Kaiser Family Foundation. That’s a heartbreaking number, especially when a program exists that could drastically reduce those costs.

The good news? There’s a federal program specifically designed to help, and it’s called Extra Help with Medicare Part D costs (sometimes called the Low-Income Subsidy, or LIS). This program can save qualifying seniors an average of $5,300 per year on prescription drug expenses, according to the Centers for Medicare & Medicaid Services (CMS).

Yet millions of people who qualify have never applied — often because they simply don’t know it exists or assume they won’t qualify. In this guide, we’ll walk you through exactly what Extra Help is, who qualifies, how to apply, and what you can expect once you’re enrolled.

What Is Extra Help (Low-Income Subsidy) for Medicare Part D?

Extra Help is a Medicare program run through the Social Security Administration (SSA) that helps people with limited income and resources pay for their Medicare Part D prescription drug coverage. If you qualify, Extra Help can pay for some or all of the following costs:

• Monthly Part D premiums — the amount you pay each month for your drug plan
• Annual deductibles — the amount you pay out-of-pocket before your plan starts covering costs
• Prescription copayments — your share of the cost each time you fill a prescription

Depending on your level of eligibility, Extra Help could reduce your copays to as little as $0 to $4.50 per prescription for generic drugs and $0 to $11.20 for brand-name drugs in 2024. For a deeper look at how Part D fits into the bigger picture, visit our Medicare Benefits Hub.

Who Qualifies for Extra Help in 2024?

To qualify for Extra Help in 2024, you generally must meet these criteria:

1. You’re enrolled in Medicare Part A and/or Part B.
2. You reside in one of the 50 states or the District of Columbia.
3. Your annual income is below approximately $22,590 for an individual or $30,660 for a married couple living together.
4. Your resources (savings, investments, real estate other than your home) are below $17,220 for an individual or $34,360 for a married couple.

Here’s what many people don’t realize: your home, your car, personal belongings, life insurance policies, and burial plots do NOT count as resources. So even if you own your home outright, you could still qualify.

According to the Medicare Payment Advisory Commission (MedPAC), roughly 2 million additional people are estimated to be eligible for Extra Help but have not yet applied. Don’t be one of them.

How to Apply for Extra Help: 3 Easy Methods

1. Apply Online Through Social Security

The fastest method is to visit ssa.gov/extrahelp and complete the application online. It takes about 15–20 minutes, and you’ll receive a decision by mail, usually within a few weeks.

2. Call Social Security Directly

If you prefer speaking with someone, call the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778). Representatives are available Monday through Friday, 8:00 AM to 7:00 PM local time.

3. Visit Your Local Social Security Office

You can also apply in person at your local Social Security office. Bring identification, proof of income, and information about your bank accounts and investments.

To stay organized throughout the process, download our free Medicare checklist — it covers all the key steps and documents you’ll need.

What Happens After You’re Approved?

1. You’ll receive a notice by mail confirming your eligibility and the level of Extra Help you qualify for.
2. If you already have a Part D plan, your lower costs will automatically kick in within one to two billing cycles.
3. If you don’t yet have a Part D plan, Medicare will enroll you in one. Qualifying for Extra Help gives you a Special Enrollment Period, so you can switch plans at any time without penalty.
4. You may also qualify for your state’s Medicare Savings Program.

Other Ways to Lower Your Medicare Part D Costs

• Ask your doctor about generic alternatives. Generics can cost 80–85% less than brand-name drugs.
• Review your Part D plan annually during Open Enrollment (October 15 – December 7).
• Use your plan’s preferred pharmacy. Many Part D plans offer lower copays at specific pharmacies.
• Look into pharmaceutical company patient assistance programs.
• Contact your State Health Insurance Assistance Program (SHIP) at 1-877-839-2675 to find your local SHIP.

Don’t Leave Thousands of Dollars Unclaimed

The Extra Help program exists for one reason: to make sure that cost isn’t a barrier between you and the medications you need to stay healthy. With potential savings averaging $5,300 per year, it’s one of the most valuable — and most underused — benefits available to Medicare beneficiaries.