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Medicare Extra Help (LIS) — free or near-free drugs if you qualify
The Low Income Subsidy cuts Part D premiums, deductibles, and copays to near zero. It's underused — more than 2 million eligible seniors aren't enrolled.
Extra Help — officially the Low Income Subsidy (LIS) — is a federal benefit that cuts Medicare Part D premiums, deductibles, and copays to nearly zero for qualifying beneficiaries. If you receive it, your drug costs drop from hundreds per month to a few dollars per prescription.
Despite being free, more than 2 million eligible seniors aren’t enrolled, according to the Social Security Administration. Many don’t know it exists; others assume they won’t qualify. Here’s how to check.
Who qualifies for Extra Help in 2026
As of 2026, the thresholds are:
- Income: Up to $23,475/year for an individual, $31,725 for a married couple (150% of federal poverty level). Alaska and Hawaii have higher thresholds.
- Resources: Up to $17,600 for an individual, $35,130 for a couple. Resources include checking and savings accounts, stocks, and bonds — but not your home, car, furniture, burial plot, or life insurance policies under $1,500.
If you have both Medicare and Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program, you qualify automatically — no application needed. For everyone else, you apply.
What Extra Help actually pays
Under the full Extra Help benefit, you pay:
- $0 premium for any Part D plan at or below your state’s benchmark premium
- $0 deductible
- $4.90 per generic prescription, $12.15 per brand-name (2026 figures) — or $0 if you’re in a long-term care facility or meet certain additional criteria
- No late-enrollment penalty even if you delayed signing up for Part D
How to apply
- Online: ssa.gov/benefits/medicare/prescriptionhelp — about 15 minutes.
- Phone: Call SSA at 1-800-772-1213.
- In person: Visit any Social Security office.
- By mail: Request form SSA-1020 and mail it back.
SSA decides in about 30-60 days. You’ll get a letter telling you whether you qualify, at what level, and when coverage starts.
Partial vs. full Extra Help
There are two levels. Before 2024, partial Extra Help had higher copays; since 2024 (under the Inflation Reduction Act), partial was eliminated — everyone who qualifies now gets the full benefit. If you were previously on partial, your copays dropped automatically in 2024.
What if my income changed?
You can apply any time — there’s no annual enrollment window. If you lose a job, take a lower-paying one, or experience a qualifying life change, reapply. If you’re denied and then your income drops, apply again.
Frequently asked questions
- How much can Extra Help save me?
- If you qualify, you typically go from paying a Part D monthly premium plus deductible plus tiered copays to paying $0 premium, $0 deductible, and just $4.90-$12.15 per prescription. For patients on multiple brand-name drugs, this can save $2,000-$5,000 per year.
- Do I have to reapply every year?
- No. Once approved, Extra Help renews automatically as long as your income and resources stay below the thresholds. SSA does an annual review; if you still qualify, nothing changes. If your situation changes significantly, you should update SSA.
- What if I have retirement savings — does that count as resources?
- Money in a 401(k) or IRA counts as a resource. Money in pension plans or annuities you haven’t started drawing may not count. The rules are specific — don’t assume you’re ineligible without applying. The resource limits ($17,600 individual / $35,130 couple in 2026) are higher than many people expect.
- Can I still use manufacturer patient assistance programs if I have Extra Help?
- Usually not needed — with Extra Help your drug copays are already $4.90-$12.15. But if a specific drug still creates hardship, some manufacturer programs have separate eligibility and you can ask. Never decline Extra Help in the hope of using a copay card; Medicare beneficiaries can’t legally use copay cards anyway.
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