Extra Help for Drugs
$5,300/yr saved. 3M+ seniors miss this.
What Extra Help is
- Federal program for prescription drug costs.
- Also called Low Income Subsidy (LIS).
- Pays Part D premiums + deductibles.
- Drug copays $0-12 (vs $50-300 normally).
- 2024 expansion = more eligible than ever.
- Saves average $5,300/year.
2026 income limits
- Individual: under $23,475/year ($1,956/mo).
- Couple: under $31,725/year ($2,644/mo).
- Asset limit: $17,820 individual, $35,640 couple.
- Excludes home + 1 vehicle + burial fund.
- Higher limits than Medicare Savings Programs.
- Many seniors qualify, don't know.
Auto-enrolled if
- You have Medicaid + Medicare.
- You have Medicare Savings Program (QMB/SLMB).
- You receive SSI.
- Otherwise — must apply.
Apply
- Apply at SSA.gov/extrahelp.
- Or call 1-800-772-1213.
- Also state Medicaid office.
- Free help: SHIP counselors.
- Decisions in 30-60 days.
- Backdated to month of application.
2025-26 Inflation Reduction Act benefits
- $2,000 yearly cap on out-of-pocket Part D costs (2025+).
- Insulin capped $35/month for ALL seniors.
- Free vaccines on Part D.
- $0 copays for ALL Extra Help recipients.
- HUGE benefit if expensive medications.
Drug cost alternatives
- GoodRx — discount card. Sometimes beats insurance copays.
- Patient assistance programs — manufacturers free for low-income.
- $4 generic lists — Walmart, Walgreens.
- Cost Plus Drugs — Mark Cuban's pharmacy. 10-90% off.
- Mail-order 90-day — Express Scripts, Caremark cheaper.
- Compare every renewal.
Don't skip meds
Skipping prescriptions costs MORE — hospitalization, complications. Help is available. NeedyMeds — needymeds.org. Free patient assistance directory. RxAssist — rxassist.org. Pharmaceutical assistance programs. Apply for ALL — some manufacturers cover 100%.