What is Extra Help for Medicare Part D and who qualifies?
The short answer
Extra Help is a federal program that reduces what people with limited income and resources pay for Medicare Part D prescription drug coverage. It can lower or eliminate drug plan premiums, deductibles, and copays.
The full explanation
Extra Help, sometimes called the Low Income Subsidy or LIS, is designed for people who have Medicare but struggle to afford the cost of prescription drug coverage. Without help, Part D costs include a monthly premium, an annual deductible, and copays or coinsurance at the pharmacy. Those costs add up fast, especially for people on multiple medications.With Extra Help, those costs can drop significantly. Some people who qualify pay very little at the pharmacy, sometimes just a few dollars per prescription, and may have little to no premium for their drug plan.To qualify, you generally need to have income below roughly 150 percent of the Federal Poverty Level and have limited financial resources, meaning savings, checking accounts, and certain other assets below a set threshold. The exact limits adjust each year, so it's worth checking current figures. People who already receive Medicaid, Supplemental Security Income (SSI), or participate in a Medicare Savings Program are typically automatically enrolled in Extra Help.You apply through Social Security, either online at ssa.gov, by phone, or at a local Social Security office. There is no cost to apply and no obligation.
Related Medicare Resources
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Utah's Aging and Disability Resource Centers (ADRC) can help you apply for Extra Help at no charge. They can also check whether you qualify for Utah's Medicare Savings Programs at the same time, since many people qualify for both.
What this means for you
For you, this means if prescription costs feel unmanageable, Extra Help could make a meaningful difference in what you actually pay at the pharmacy each month.
Related Questions
What are Medicare Savings Programs and what costs can they cover?
Can I get help paying my Medicare premiums or other costs?
Do I get a Special Enrollment Period if I lose Medicaid or qualify for Extra Help?
What is the Part D late enrollment penalty and how is it calculated?
If I am on a fixed income in Utah, what Medicare help programs should I check first?
