Federal: Extra Help with Prescription Drugs

The Federal Extra Help program, officially known as the Low-Income Subsidy (LIS) program, is designed to assist individuals with limited income and resources in affording their Medicare Part D prescription drug coverage. Medicare Part D provides coverage for prescription medications, and the Extra Help program helps eligible beneficiaries with lower prescription drug costs, including premiums, deductibles, and copayments.

Here are the key points to understand about the Federal Extra Help program:

1. Eligibility: To qualify for Extra Help, you must have Medicare Part A and/or Part B and be enrolled in a Medicare Part D prescription drug plan. Your income and resources (such as savings, investments, and real estate, but not your home or car) are considered in determining eligibility.

2. Benefits: If you qualify for Extra Help, you’ll receive assistance with your Part D premiums, deductibles, and copayments or coinsurance. The amount of assistance you receive depends on your income and resources.

3. Income and Resource Limits: The specific income and resource limits for eligibility change annually. People with limited income and resources might qualify for full or partial Extra Help. Generally, if your income and resources fall below a certain threshold, you’ll qualify for more comprehensive assistance.

4. Automatic Enrollment: Some individuals who automatically qualify for Extra Help due to their enrollment in Medicaid or Supplemental Security Income (SSI) will be enrolled in a Medicare Part D plan with no premiums or deductibles. Others might need to apply for Extra Help separately.

5. Application Process: You can apply for Extra Help through the Social Security Administration (SSA). You can apply online, by phone, or at your local SSA office. The SSA will review your application and notify you about your eligibility and the level of assistance you qualify for.

6. Open Enrollment: If you’re eligible for Extra Help, you can switch Medicare Part D plans or make changes during the Annual Enrollment Period (October 15 to December 7) each year. You can apply for Extra Help throughout the year if your circumstances change.

The Federal Extra Help program is a valuable resource for individuals with limited income and resources to make their prescription medications more affordable. If you think you might qualify, applying for Extra Help is recommended to ensure you’re receiving the assistance you’re eligible for.