Mark LuigiIf you’re on Medicare and struggling to afford your prescriptions, there’s a federal program that could cut your drug costs dramatically — and millions of eligible seniors never apply for it. It’s called Extra Help, and it could be worth up to $5,700 a year to you.
What Is Extra Help?
Extra Help — also known as the Low-Income Subsidy or LIS — is a federal program run by Social Security and Medicare that helps people with limited income and resources pay for their Medicare Part D prescription drug coverage. It can reduce or eliminate your Part D premiums, deductibles, and co-pays for covered medications.
Think of it as a financial cushion built specifically for seniors and people with disabilities who need prescription drug coverage but can’t easily afford what Medicare Part D asks them to pay out of pocket.
How Much Can It Actually Save?
The estimated average annual value of Extra Help is $5,700 per person. Here’s what that can look like in practice:
- No Part D premium: In most cases, Extra Help covers your monthly drug plan premium entirely.
- No deductible: The annual Part D deductible (up to $590 in 2025) is waived.
- Drastically reduced co-pays: In 2025, you pay no more than $4.90 for generic drugs and $12.15 for brand-name drugs per prescription. Once your total out-of-pocket drug costs reach $2,000, you pay $0 for the rest of the year.
- No late enrollment penalty: If you missed the deadline to sign up for Part D, Extra Help waives that penalty for as long as you receive the benefit.
Real example: Without Extra Help, a senior paying a $30/month premium, $590 deductible, and 25% of costs on a $500/month medication could pay over $2,400 a year. With Extra Help, the same senior could pay as little as $12.15 per month — a savings of more than $2,200 on just one drug.
Who Qualifies?
To qualify for Extra Help in 2025, you must:
- Be enrolled in Medicare Part A and/or Part B
- Live in one of the 50 U.S. states or Washington, D.C.
- Have annual income below $23,475 (individual) or $31,725 (married couple)
- Have resources (savings, investments) below $17,600 (individual) or $35,130 (couple)
Important: Not all income counts. Food assistance (SNAP), housing assistance, and home energy assistance are excluded from the income calculation. You may qualify even if your gross income looks slightly higher than the limit.
If you already receive Medicaid, Supplemental Security Income (SSI), or are enrolled in a Medicare Savings Program, you qualify for Extra Help automatically and don’t need to apply separately.
How to Apply
Applying is free and straightforward. You have three options:
- Online: Visit ssa.gov and search “Extra Help application” (Form SSA-1020). It takes about 15 minutes.
- By phone: Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778), Monday through Friday, 7 a.m.–7 p.m.
- In person: Visit your local Social Security office. No appointment needed, though calling ahead is recommended.
You can also get free help applying through your State Health Insurance Assistance Program (SHIP). Call 1-800-677-1116 to find your local SHIP counselor — they’ll walk you through the process at no cost.
What Happens After You Apply?
Social Security will review your application and mail you a decision letter. If approved, Medicare will automatically enroll you in a Part D plan if you don’t already have one. You can switch to a different plan if you prefer — and starting in 2025, Extra Help recipients can change their drug plan once per month throughout the year.
If your income or resources change — in either direction — you can reapply for Extra Help at any time. Even if you were turned down before, it’s worth checking again each year as limits are updated.
Don’t leave money on the table: An estimated 1 in 3 people who qualify for Extra Help never apply. If your income is modest and prescriptions are straining your budget, applying costs nothing and could save you thousands every year.
Need help understanding Medicare benefits? Visit Smarter Senior Living — we search so you don’t have to.
