What Extra Help does
Extra Help—also called the Part D Low-Income Subsidy—is a Medicare program for people with limited income and resources. It can help pay Medicare drug-plan premiums, deductibles, coinsurance and other Part D costs. People receiving Extra Help also do not pay a Part D late-enrollment penalty while they have the assistance.
Medicare has published the 2027 prescription amounts
For people who qualify for Extra Help in 2027, Medicare says the plan premium and plan deductible will be $0. At a participating pharmacy, the cost for a covered prescription will be no more than $5.80 for a generic drug and $14.40 for a brand-name drug. After total covered drug costs—including certain payments made on the beneficiary’s behalf—reach $2,400, the beneficiary pays $0 for each covered drug for the rest of the year.
These are Extra Help amounts, not the standard costs for everyone with Part D. Plan formularies and participating pharmacies still matter.
Who gets Extra Help automatically?
Medicare says some people qualify automatically, including people who have full-benefit Medicaid, receive help from a Medicare Savings Program paying Part B premiums, or receive Supplemental Security Income (SSI). Medicare sends a notice explaining the assistance and, when necessary, how drug-plan enrollment will be handled.
If you are not automatically enrolled, it may still be worth applying
Other beneficiaries can apply based on income and resources. Medicare currently lists 2026 limits of $23,940 in annual income and $18,090 in resources for an individual, or $32,460 in income and $36,100 in resources for a married couple. Medicare notes that these limits can change each year, so do not assume you will be ineligible in 2027 based only on an older figure.
Not everything you own is counted as a resource. Medicare and Social Security provide the official rules, and a State Health Insurance Assistance Program (SHIP) can provide free application help.
Extra Help and Medicare Savings Programs can work together
Medicare notes that you can apply for Extra Help and a Medicare Savings Program at the same time. Medicare Savings Programs are administered by states and may help with other Medicare costs, including Part A or Part B premiums and, for some people, deductibles and coinsurance. Eligibility rules can differ by state.
Why check before Open Enrollment?
Medicare Open Enrollment runs from October 15 through December 7. If prescription costs are a concern, knowing whether you receive—or may qualify for—Extra Help changes how you should evaluate Part D and Medicare Advantage plans with drug coverage. A plan that looks expensive under standard cost-sharing may look very different when the Extra Help rules are applied.
Even with Extra Help, compare whether your prescriptions are on the plan’s formulary and whether your preferred pharmacies participate. Assistance with costs does not make every plan identical.
A simple checklist
- Look for any Medicare or Social Security notice about Extra Help.
- If you already receive Extra Help, confirm that your status continues for 2027 and review any notice about your drug plan.
- If you do not receive Extra Help, review the current eligibility rules rather than assuming you earn or own too much.
- Keep a current prescription list and preferred pharmacies ready for your 2027 plan comparison.
- If you qualify for Medicaid, SSI or a Medicare Savings Program, ask whether Extra Help should be automatic in your situation.