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Need Extra Help Paying for Medicare Part D?

Joanne BentelerNovember 28, 2023

Need Extra Help Paying for Medicare Part D?

Extra Help could be just what you need to make your Medicare Part D prescription costs affordable. The Medicare Extra Help program can save eligible beneficiaries money by lowering prescription drug costs.

What is the Medicare Extra Help program?

The Extra Help program, also called the Low-Income Subsidy (LIS), pays Part D premiums, deductibles, and copayments related to a Medicare prescription drug plan. The program, run by the Social Security Administration (SSA), is available to beneficiaries with limited income and resources.

If you qualify for Extra Help in 2024, you will pay:

  • $0 for your Medicare drug plan premium
  • $0 for your plan deductible
  • A reduced amount for both generic and brand-name drugs:
    • You will pay small copayments for your medicines until you reach the catastrophic phase of Part D. Once you do, you will not have to pay anything for your drugs.

⊕ Read our blog, Medicare Part D Donut Hole Explained, to learn more about the 4 phases of Part D coverage.

Medicare charges a penalty if you don’t sign up for Part D drug coverage when you’re first eligible. If you get Extra Help, you will not be charged this penalty.

Who is eligible for Extra Help?

You must meet all of the requirements to be eligible for Extra Help:

  • Have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance)
  • Live in the United States
  • Be enrolled in or eligible for a Part D prescription drug plan
  • Meet the income limit
  • Meet the resource limit

What are the income and resource thresholds to qualify for Extra Help?

If your 2023 income is below 150% of the federal poverty line (FPL), you qualify.

You Are Income Threshold  Resource Threshold
Single $21,870 $16,660
Married $29,580 $33,240

The FPL is slightly higher for those living in Alaska and Hawaii.

What counts as a resource?

Resources include the value of the things you own. To qualify for Extra Help, your resources must be limited to $16,660 for an individual or $33,240 for a married couple living together. Some examples include:

  • Real estate (other than your primary residence)
  • Bank accounts: checking and savings accounts, and certificates of deposit (CDs)
  • Stocks
  • Bonds, including U.S. Savings Bonds
  • Mutual funds
  • Individual Retirement Accounts (IRAs)
  • Cash at home or anywhere else

What does not count as a resource?

The following resources do not count toward the Extra Help threshold:

  • Your primary residence
  • Your personal possessions
  • Your vehicle(s)
  • Resources you couldn’t easily convert to cash, such as jewelry or home furnishings
  • Property you need for self-support, such as rental property or land you use to grow produce for home consumption
  • Non-business property essential to your self-support
  • Life insurance policies
  • Burial expenses
  • Interest earned on money you plan to use for burial expenses

How do I apply for Extra Help?

Some people automatically qualify for Extra Help; others have to apply. You’ll automatically receive Extra Help if you:

  • Have full Medicaid coverage
  • Get help from your state paying your Part B premiums
  • Get Supplemental Security Income (SSI) benefits from Social Security

If you don’t automatically qualify for Extra Help, you can:

  • Complete an online application
  • Call the SSA at 800-772-1213 (TTY: 800-325-0778)
  • Visit your local Social Security office
  • Get help from a Medicare licensed broker, like American Exchange

What documents do you need to apply?

Gather these documents for you and your spouse, if you have one:

  • Bank statements and tax returns
  • Individual Retirement Account (IRA) or 401(k) account balances
  • Statements for pensions, Veterans’ benefits, annuities, and Railroad Retirement Board benefits

American Exchange can help! 

American Exchange can help you apply for Extra Help or other prescription drug savings programs. We can also help you find the Medicare plan available in your area that best meets your health and budgetary needs. Contact us today.

1.888.995.1674          View our Medicare webpage

Schedule an Appointment

Our Medicare experts are available to help you:

Monday through Friday from 8:00 a.m. to 5:00 p.m.

Extended hours during open enrollment (November 1, 2023 – January 15, 2024):

Saturdays from 8:00 a.m. – 5:00 pm Eastern Time 

We are closed on the following holidays:
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Christmas: December 23-25
New Year’s Day: January 1

Free Medicare Resources

We publish a Medicare blog on the 4th Tuesday of every month, and more frequently during Medicare’s Annual Enrollment Period. Be sure to read our Medicare blog posts or flyers to better understand your coverage.

Medicare Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

American Exchange is a licensed health insurance broker. Robert Huffaker, NPN 13568432

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