To qualify for Extra Help, you must:
- Live in the United States
- Be enrolled in or eligible for a Part D prescription drug plan
- Meet the income limit
- Meet the resource limit
Also known as the Part D Low Income Subsidy (LIS), Extra Help is estimated to be worth about $5,300 per year.1 Here’s a look at who qualifies, the benefits and how to apply.
To qualify for Extra Help, you must:
In most cases, your income and resources must be below a certain limit to qualify for Extra Help. The limits for 2023 are:2
Income refers to how much money you (and your spouse if you’re married) make in a calendar year.
Resources include the value of the things you own. Some examples include:
There are 2 levels of Extra Help: full and partial. Here’s a breakdown of their benefits:3
Full Extra Help supports people who are on Medicare and also qualify for their state’s Medicaid program. Benefits include:
Once your total drug costs (what both you and your plan pay) reach $7,400, you’ll pay $0 for each covered drug. If you also get full Medicaid coverage and are in the Qualified Medicare Beneficiary (QMB) program, you’ll pay no more than $4.30 for each covered drug.
Some people with higher incomes may be able to get partial Extra Help. These benefits include:
Once your total drug costs (what both you and your plan pay) reach $7,400, you’ll pay no more than $4.15 for each generic drug and $10.35 for each brand-name drug.
In addition to lower out-of-pocket costs, Extra Help gives you:
Some people automatically qualify for Extra Help and others have to apply. You'll automatically receive Extra Help if you get:4
If you don’t automatically qualify for Extra Help, you can apply through the Social Security Administration in 3 ways:
Note: If you don’t qualify for Extra Help now, you can reapply at any time if your income and resources change.
Extra Help can help pay for all or most of your monthly Medicare premiums and
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