Submitted by Bob O’Donnell, Owner, BARDO Insurance
What is Extra Help? “Extra Help” is a Medicare program to help people with limited income and resources pay Medicare drug coverage (Part D) premiums, deductibles, coinsurance, and other costs. You also won’t have to pay a Part D late enrollment penalty while you get Extra Help. The formal name for the prescription assistance is Low Income Subsidy, and referred to frequently by its acronym, LIS.
Some people qualify for Extra Help automatically, and other people have to apply.
Who gets Extra Help Automatically?
You’ll get Extra Help automatically if you get:
- Full Medicaid coverage
- Help from your state paying your Part B premiums (from a Medicare Savings Program)
- Supplemental Security Income (SSI) benefits from Social Security
- You’ll get a letter about your Extra Help. It tells you things like how much you’ll pay, and your new Medicare drug plan, if you don’t have one already.
If you don’t automatically get Extra Help, you can apply for it:
https://secure.ssa.gov/i1020/start , or call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.
You can apply for Extra Help and Medicare Savings Programs (MSPs) at the same time. These state programs provide help with other Medicare costs. Social Security will send information to your state to initiate an MSP application unless you tell them not to on the Extra Help application.
Who Should Apply for Extra Help? In most cases, to qualify for Extra Help, you must have income and resources below a certain limit. These limits go up each year.
The income limit is based on your income from the previous year.
Income and resource limits in 2025:
Individual Annual Income Limit: $23,475 Resource Limit: $17,600
Married Couple Annual Income Limit: $31,725 Resource Limit: $35,130
What counts in resource limits?
- Money in a checking, savings, or retirement account
- Stocks
- Bonds
- States don’t count:
- Your home
- One car
- Burial plot
- Up to $1,500 for burial expenses if you have put that money aside
- Furniture
- Other household and personal items
If you qualify for Extra Help Medicare will automatically enroll you in a Medicare drug plan (Part D), if you don’t have one already.
- You’ll get a letter telling you:
- About your new plan. You can pick a different Medicare drug plan if you want.
- What you’ll pay, depending on the “level” of Extra Help you get.
- That you get Extra Help for the rest of the calendar year. Even if your income changes in the middle of the year, you’ll keep getting Extra Help through December 31.
- If you meet the income and resource limits for next year, you’ll keep getting Extra Help. We’ll mail you a letter only if:
- Your Extra Help changes.
- You no longer qualify for Extra Help.
- You get moved to a different plan for next year.
If you don’t get a letter from Medicare or Social Security, you’ll keep the same level of Extra Help and same plan for next year.
Even if you don’t qualify for Extra Help now, you can reapply for Extra Help any time if your income and resources change.
(Information courtesy of the Centers for Medicare and Medicaid Services)