Understanding Medicare's Extra Help Program to reduce Prescription Drug Costs.

The following information is intended to provide general information to current and prospective beneficiaries. It is not intended to draw attention to a particular plan or plans, influence a beneficiary's decision-making process when selecting a plan, or influence a beneficiary's decision to stay enrolled in any particular plan.

Extra Help (also known as the Low-Income Subsidy, or LIS, program) is designed to provide assistance to qualified Medicare beneficiaries with limited income and resources to help them afford their prescription drug costs.

To qualify for Extra Help in 2026, your income (as an individual) must be under $23,940 with assets under $18,090. If you are married, your income must be under $32,460 with assets under $36,100.

If you qualify, you can expect:

• Reduced or Eliminated Part D Premiums: Your Medicare Part D prescription drug plan premiums can be either significantly reduced or completely covered by the subsidy.

• Lower cost-sharing: You will have lower deductibles, copayments, and coinsurance for your medications.

• Catastrophic Coverage: For those with Extra Help, cost-sharing in the catastrophic coverage phase is eliminated.

What's more, qualifying for Extra Help can help you avoid the Part D late enrollment penalty, if you are subject to it.

• The Part D penalty is a lifetime premium increase imposed by Medicare if you go without creditable prescription drug coverage for a continuous period of 63 days or more after your Medicare Initial Enrollment Period (IEP) has ended.

• If you qualify for Extra Help and do not have Part D coverage, you will be granted a Special Enrollment Period (SEP) during which you can enroll in a Part D plan without incurring the penalty.

• If you have already been paying the Part D penalty at the time you qualify, it will be waived moving forward as long as you qualify for Extra Help and you maintain drug coverage.

If you are on Minnesota's Medical Assistance (MA) or have qualified for Part B premium reductions through a Medicare Savings Plan (MSP), your enrollment in Extra Help should be automatic. If not, you'll have to apply. To find out if you qualify for Extra Help (Low-Income Subsidy) under Medicare and to apply, you can:

• Visit the Social Security Administration (SSA) website, which provides information on eligibility criteria and an online application tool.

• Call the Social Security Administration: 1-800-772-1213 (TTY 1-800-325-0778) to get assistance with the application process.

• Contact a licensed insurance agent knowledgeable in Medicare who can help you access the valuable benefits provided by the Extra Help program. These services are available at no cost to you.

  
  

Overall, Extra Help plays a vital role in making healthcare more affordable and accessible for low-income Medicare beneficiaries. It contributes to better health outcomes, financial stability, and an improved quality of life for those who may otherwise struggle to afford necessary prescription drugs. If you believe you may be a candidate for Extra Help, Contact Milestone Medicare today. Qualifying for the program could save you thousands of dollars annually while also helping you achieve peace of mind, helping you access the medications you need without facing financial barriers.