Extra Help With Medicare Prescription Drug Costs

What is Extra Help?

Extra Help is a federal program that lowers what you pay for Medicare prescription drug coverage. You may also hear it called the Part D Low-Income Subsidy, or LIS. They are the same thing.

It is run by Social Security, not by an insurance company and not by us. Applying is free.

What does Extra Help pay for?

• Your Part D plan premium
• The Part D deductible
• Copays and coinsurance on covered drugs
• The Part D late enrollment penalty, for as long as you have Extra Help

It does not pay your Medicare Part B premium. That is a different program — see help paying your Part B premium in Washington.

2026 income and resource limits

Read the next two sections before you decide these numbers rule you out. They very often do not.

Who gets Extra Help automatically?

You do not need to apply if you already have any of these:

• Full Medicaid — in Washington, Apple Health
• A Medicare Savings Program that pays your Part B premium
• Supplemental Security Income (SSI)

If you have one of those and you are still paying full price at the pharmacy, something has gone wrong. That is worth a phone call to Social Security or your plan.

What counts as resources?

Resources means things like money in checking and savings, and stocks and bonds. It does not include the home you live in, and generally does not include one vehicle, your personal belongings, or a burial plot.

People talk themselves out of applying over a savings account that would not have counted the way they assumed.

What if I am slightly over the limit?

Apply anyway. The rules contain exclusions and special circumstances, and the figure Social Security calculates is often lower than the number you arrived at yourself. A rejection costs you an afternoon. Not applying, when you would have been approved, costs you every month.

There is also a partial subsidy for some people who do not qualify for the full one.

How to apply through Social Security

Apply online, by phone, or at a Social Security office. You do not need an insurance agent to file it, and nobody should charge you.

Do not send us your documents. American Senior Choices does not process assistance applications and does not determine eligibility. Send nothing containing your Social Security number, Medicare number or bank details to us or to anyone who contacts you first.

What happens after approval

Social Security writes to you. Your pharmacy costs should drop at the counter, and if you are not already in a drug plan you may be enrolled in one automatically.

When you apply, Social Security can also pass your information to the state to start Medicare Savings Program consideration — help with your Part B premium — unless you opt out. That is usually worth leaving switched on.

How Extra Help affects your plan choices

Receiving Extra Help changes what your drug coverage costs, and it can also open up opportunities to change plans outside the usual enrollment windows. Which plan makes sense can look different afterward, because the plan that was cheapest for you before may not be the one that fits best now.

That is a conversation worth having once your approval letter arrives, not before.

If the pharmacy charges you the wrong amount

It happens, usually because the pharmacy's system has not caught up with your approval. Bring your approval letter or your Medicaid card to the counter. If that does not resolve it, call your drug plan. If you are still stuck, call 1-800-MEDICARE.

Do not pay a price you know is wrong and hope to sort it out later.

LI NET: temporary coverage while things sort out

LI NET is a Medicare program that can provide temporary prescription coverage for people who have Extra Help or Medicaid but are not yet enrolled in a drug plan. It is designed for exactly the gap where somebody is approved on paper but has nothing to show at the pharmacy.

Ask your pharmacist about LI NET, or call 1-800-MEDICARE. Coverage periods and time limits are set by Medicare, so confirm the current rules with them rather than relying on anything you read second-hand.

Questions people actually ask

Official sources

• Social Security — Extra Help with Medicare prescription drug costs
• Medicare.gov — Help with drug costs

Related

• Help paying your Medicare Part B premium in Washington
• What "dual eligible" means in Washington
• All ways to lower prescription costs
• What help should I check?
• All financial assistance resources

Last reviewed September 2026. American Senior Choices does not determine eligibility for government assistance programs. Eligibility is determined by the appropriate government agency. Program rules, income limits, resource limits and benefits can change.