Also known as the Part D Low Income Subsidy (LIS), “Extra Help” is estimated to be worth about $6,200 per year.1 Here’s a look at who qualifies, the benefits and how to apply.
What is Medicare “Extra Help?” (Medicare Part D’s Low-Income Subsidy)
3-minute readPublished 03/28/2024Updated 03:42 PM EST, 03/26/2025
Who qualifies for Medicare “Extra Help?”
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
Learn more about Medicare
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3-minute readPublished 03/28/2024Updated 03:42 PM EST, 03/26/2025
Medicare “Extra Help” income and resource limits
In most cases, your income and resources must be below a certain limit to qualify for “Extra Help.” The limits for 2025 are:1
Your situation | Income limit | Resource limit |
|---|---|---|
Single | $22,590 | $17,600 |
Married couple living together | $30,660 | $35,130 |
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:
- Real estate (other than your primary residence)
- Bank accounts (checking, savings and certificates of deposit)
- Stocks
- Bonds (including U.S. Savings Bonds)
- Mutual funds
- Individual Retirement Accounts (IRAs)
- Cash at home or anywhere else
What are the benefits of Medicare “Extra Help?”3
“Extra Help” supports people who are on Medicare and also qualify for their state’s Medicaid program. 2025 benefits include:2
- No or reduced monthly premium
- No annual deductible
- Paying no more than $4.90 for each generic/preferred multi-source drug or biosimilar
- Paying no more than $12.15 for all other drugs
Once your total drug costs (including certain payments made on your behalf, like through the Extra Help program) reach $2,000, you’ll pay $0 for each covered drug.
Other benefits of “Extra Help”
In addition to lower out-of-pocket costs, “Extra Help” gives you:
- No
Part D late enrollment penalty —Medicare charges this penalty to people who don’t sign up for Part D drug coverage when you’re first eligible for a Part D plan. You will not be charged this penalty. - Special Enrollment Periods—Most people with Medicare can only make changes to their drug coverage at certain times of the year. If you get “Extra Help,” you may have access to these
special enrollment periods .
How do I apply for “Extra Help?”
Some people automatically qualify for “Extra Help” and others have to apply. You'll automatically receive “Extra Help” if you get:
- Full Medicaid coverage
- Help from your state paying your Part B premiums
- Supplemental Security Income (SSI) benefits from Social Security
If you don’t automatically qualify for “Extra Help”, you can apply through the Social Security Administration in 3 ways:
- Online—
Go to the Social Security Administration’s website - Phone—Call 800-772-1213 (TTY: 800-325-0778)
- In person—Visit your
local Social Security office
Note: If you don’t qualify for “Extra Help” now, you can reapply at any time if your income and resources change.
If you qualify for Extra Help
Every member is responsible for following all the rules and procedures in the Evidence of Coverage (EOC). Download this document in the appropriate language below.
A little can go a long way
“Extra Help” can help pay for all or most of your monthly Medicare premiums and
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3-minute readPublished 03/28/2024Updated 03:42 PM EST, 03/26/2025
Sources
Understanding the Extra Help with Your Medicare Prescription Drug Plan ,” Social Security Administration, last accessed Feb. 5, 2025.- “
Help with drug costs ,” Medicare.gov, last accessed Feb. 5, 2025.