Medicare Extra Help (LIS): Reduce Your Drug Costs Significantly

# Medicare Extra Help (LIS): Reduce Your Drug Costs Significantly

Medicare Extra Help, also called the Low Income Subsidy (LIS), helps Medicare beneficiaries with limited income and resources pay for prescription drugs. This program can save qualifying individuals up to $5,000 or more per year on drug costs.

What Extra Help Covers

If you qualify for Extra Help, Medicare pays for:

Premium Assistance

Part of or all of your Part D monthly premium
Amount depends on your income level

Deductible Elimination

No annual Part D deductible
Full Extra Help eliminates it completely

Reduced Copays

Generic drugs: $0 - $4.50
Brand-name drugs: $0 - $11.20
Amount depends on level of Extra Help

No Coverage Gap

Extra Help eliminates the donut hole
Low copays continue throughout the year

Who Qualifies for Extra Help?

Income Limits (2025)

Individual: Up to approximately $22,590/year
Married couple: Up to approximately $30,660/year

Resource Limits (2025)

Individual: Up to $17,220
Married couple: Up to $34,360

Note: These limits change annually and may vary. Some resources don't count.

Resources That Don't Count:

Your home
One car
Burial plots for you and immediate family
Up to $1,500 per person for burial expenses
Personal possessions
Life insurance policies

Levels of Extra Help

Full Extra Help

For those with the lowest income and resources:

$0 monthly premium (for benchmark plans)
$0 deductible
Copays: $0 for full dual-eligibles, up to $4.50 generic / $11.20 brand for others

Partial Extra Help

For those with slightly higher income/resources:

Sliding scale premium assistance
Reduced deductible
15% coinsurance after deductible

How to Apply for Extra Help

Apply online at ssa.gov/extrahelp
Call 1-800-772-1213
Visit your local Social Security office

Option 2: State Medicaid Office

Apply through your state Medicaid program
May automatically qualify you for Extra Help

Option 3: Medicare Advisor Assistance

We can help you complete the application
Ensure you include all relevant information

Documentation Needed

Have this information ready when applying:

Your Medicare number
Income information (Social Security, pensions, wages)
Bank account balances
Stocks, bonds, and investment values
Life insurance policy details
Real estate owned (besides your home)

Automatic Qualification

You automatically qualify for Extra Help if you have:

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Full Medicaid coverage
Supplemental Security Income (SSI)
Medicare Savings Program enrollment (QMB, SLMB, QI)

If you auto-qualify: You don't need to apply—you'll be enrolled automatically.

Extra Help and Plan Selection

Benchmark Plans

"Benchmark" Part D plans charge $0 premium to Extra Help recipients
Available plans vary by county and year

Non-Benchmark Plans

You can choose any Part D plan
May pay the difference between your plan premium and benchmark amount

Medicare Advantage with Part D

Extra Help applies to MA-PD plans too
May still owe MA premium (separate from drug coverage)

Extra Help Benefits Beyond Part D

Qualifying for Extra Help also:

Provides a Special Enrollment Period to change plans
Allows quarterly plan changes (January-September)
May indicate eligibility for other programs

Medicare Savings Programs (MSPs)

Pay your Part B premium (and sometimes more):

QMB - Pays Part A & B premiums, deductibles, coinsurance
SLMB - Pays Part B premium
QI - Pays Part B premium

State Pharmaceutical Assistance Programs (SPAPs)

Some states offer additional drug cost help beyond Extra Help.

Common Questions

Q: Will Extra Help affect my other benefits? A: Extra Help is not counted as income for other federal programs.

Q: How long does approval take? A: Typically 2-4 weeks after application submission.

Q: Can I reapply if denied? A: Yes, especially if your circumstances change.

Q: Does Extra Help cover all my drugs? A: It covers Part D drugs. Some drugs may not be covered by any Part D plan.

Get Help Applying

Our advisors help Florida residents determine Extra Help eligibility and navigate the application process. We'll also help you choose the best Part D plan to maximize your savings.

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