Medicare's Extra Help Program
Medicare provides Extra Help to pay prescription drug costs for people with limited income and resources. If you qualify, you could get help paying for Medicare Part D premiums, annual deductibles, and prescription drug copays or coinsurance. Extra Help is also called Low Income Subsidy (LIS). According to Social Security Administration (SSA), Extra Help is estimated to be worth about $4,900 per year.
Social Security will review your income and resources to determine if you are eligible. In 2019, if your income is limited to $18,735 for an individual ($25,365 for a married couple living together) AND your resources are limited to $14,390 for an individual ($28,720 for a married couple living together), you may qualify for Extra Help. Note: Income and resource limits may change each year.
You are automatically eligible for Extra Help if:
- You are eligible to receive both Medicare and Medicaid (dual eligibility)
- You have a Medicare Savings program (partial dual eligibility)
- You receive Supplemental Security Income (SSI) benefits but not Medicaid
for the Social Security Administration’s publication “Understanding The Extra Help With Your Medicare Prescription Drug Plan”.
for more information about Medicare’s Extra Help program.
for a 2019 summary of monthly plan premiums for those eligible for extra help.
Applying for Extra Help with Medicare
In most cases, you will need to apply for Extra Help either through the Social Security Administration or through your state Medicaid Office. After you apply, Social Security will review your application and will send you a letter to let you know if you qualify for Extra Help.
For more information or to apply:
- Visit your Social Security Office.
- Call the Social Security Administration toll-free at 1-800-772-1213, between 7 a.m. and 7 p.m. Monday through Friday. TTY users should call 1-800-325-0778.
- Visit the Social Security Administration's website.
Extra Help Application Forms are available by calling the Social Security Administration and by visiting the Social Security Administration's website
Records you will need to complete the Extra Help Application include:
- Statements that show your account balances at banks, credit unions or other financial institutions;
- Investment statements and stock certificates;
- Tax returns;
- Pension award letters; and
- Payroll slips.
Using the Best Available Evidence Policy (BAE)
If your Low Income Subsidy (LIS) information is incorrect, you can use the Best Available Evidence (BAE)
policy to show that you qualify. You can use such evidence as your award letter from Social Security Administration, your Medicaid card or other proof of your eligibility for Extra Help. When you provide this information to your Medicare Prescription Drug Plan, your plan will update your Low Income Subsidy information as soon as possible.
Helpful Links for Medicare Part D Extra Help
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