Extra Help for Prescription Drug Costs (LIS Program)
Prescription drug costs can add up quickly, and many Medicare beneficiaries struggle to afford their medications.
One of the best ways to lower prescription costs is by qualifying for the Medicare Part D Low‑Income Subsidy (LIS), commonly called “Extra Help.”
This federal program helps Medicare beneficiaries pay for prescription drug coverage by reducing monthly premiums and limiting drug copays.
If you qualify, Extra Help can save you thousands of dollars each year on prescription medications.
Prescription Drug Coverage (Part D)
Extra Help for Prescription Drug Costs (LIS Program)
Prescription drug costs can add up quickly, and many Medicare beneficiaries struggle to afford their medications.
One of the best ways to lower prescription costs is by qualifying for the Medicare Part D Low‑Income Subsidy (LIS), commonly called “Extra Help.”
This federal program helps Medicare beneficiaries pay for prescription drug coverage by reducing monthly premiums and limiting drug copays.
If you qualify, Extra Help can save you thousands of dollars each year on prescription medications.
What Is Medicare Extra Help?
The Low Income Subsidy (LIS) is a federal assistance program administered through the Social Security Administration that helps eligible Medicare beneficiaries afford their Medicare Part D prescription drug coverage.
For those who qualify, Extra Help provides several important benefits.
1. Premium Assistance
Extra Help may pay your Part D monthly premium up to a state benchmark amount (usually around $35–$45 per month).
This applies whether you receive prescription drug coverage through:
- A stand-alone Part D drug plan
- A Medicare Advantage plan that includes prescription drug coverage
2. Lower Prescription Copays
Extra Help significantly reduces what you pay at the pharmacy.
Your copays are capped depending on:
- Your Extra Help level
- The tier of the medication
3. Special Election Period for Plan Changes
Most Medicare beneficiaries can only change drug plans once per year during the Medicare Annual Election Period.
However, people who qualify for Extra Help receive a Special Election Period that allows them to change plans once per quarter during the first three quarters of the year.
This gives you more flexibility to switch to a better drug plan if needed.
4. Elimination of the Part D Late Enrollment Penalty
If you previously received a Medicare Part D Late Enrollment Penalty, qualifying for Extra Help will remove that penalty completely.
Medicare Extra Help Benefits (2026)
Benefits depend on whether you qualify for Full Extra Help or Partial Extra Help.
Full Extra Help
- Drug Plan Premium: $0 per month
- Drug Plan Deductible: $0 per year
Prescription Copays
- Generics: Up to $5.10
- Brand-name drugs: Up to $12.65
Partial Extra Help
Drug Plan Premium: Reduced based on income
25%, 50%, or 75% of the premium covered
Drug Plan Deductible: No more than $104
Prescription Copays: No more than 15% of the drug cost
Additional Benefit
Extra Help also eliminates the Medicare Coverage Gap, previously known as the Donut Hole.
Who Is Eligible for the Low Income Subsidy?
Eligibility for Extra Help is based on income and financial resources.
Income Limits (2026)
Single: $23,475 per year
Married: $31,725 per year
Resource Limits (2026)
Single: $18,090
Married: $36,100
Resources Medicare Counts
Medicare may count:
- Checking accounts
- Savings accounts
- Retirement accounts
- Brokerage accounts
Resources Medicare Does NOT Count
The following are typically not counted toward the resource limit:
- Your primary home
- Your vehicle
- Pre-paid funeral plans
- Personal belongings
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How to Apply for Medicare Extra Help
Some people are automatically enrolled in Extra Help.
You may automatically qualify if you:
- Receive full Medicaid coverage
- Qualify for a Medicare Savings Program
- Receive Supplemental Security Income (SSI) from Social Security
If you are not automatically enrolled, you can apply through the Social Security Administration.
Apply for Extra Help Online
To apply online, visit the official application page:
https://secure.ssa.gov/i1020/start
Scroll to the bottom of the page and select “Apply Now” to begin your application.
You will then complete several pages entering information about:
Your personal details
Your income
Your financial resources
Once your application is submitted, Medicare will review your eligibility and send a letter informing you whether you qualify and what level of Extra Help you receive.
Renewing Your Extra Help Qualification
If you qualify for Extra Help, you typically do not need to reapply every year.
However, the Social Security Administration may periodically review your eligibility.
If your eligibility changes, you will receive a letter explaining:
- Whether you still qualify
- If your level of Extra Help has changed
Common Questions the LIS Program
For those who qualify for Full Extra Help, prescription drug coverage can cost $0 per month and prescription copays are limited to very small amounts.
Partial Extra Help still significantly reduces prescription costs.
Summary
The Medicare Extra Help program can dramatically lower prescription drug costs for eligible beneficiaries.
Unfortunately, many people who qualify never apply simply because they don’t know about it.
If you need help determining whether you qualify or want assistance applying for Extra Help, schedule a consultation and we’ll be happy to guide you through the process.