What Is Medicare Extra Help and How Can It Lower Your Prescription Drug Costs in 2025?

If you’re struggling to keep up with the cost of your prescription medications, the Medicare Extra Help program could be the financial relief you’ve been looking for.

Also known as the Low-Income Subsidy (LIS), Extra Help is a federal program that assists eligible Medicare beneficiaries in paying for Medicare Part D prescription drug costs. This includes help with monthly premiums, annual deductibles, and co-payments for medications.

Why It Matters in 2025

In 2025, changes to Medicare are making Extra Help more valuable than ever. One major update: annual out-of-pocket costs for prescription drugs will be capped at $2,000 for everyone with Medicare drug coverage. If you qualify for Extra Help, your costs could be even lower—or nothing at all.

Who Can Get Extra Help?

Eligibility for Extra Help is based on your income and assets. In general, you may qualify if:

• Your income is below a certain level (specific thresholds vary slightly by year).
• Your resources (like savings and investments, not counting your home or car) fall under the program’s limits.

Some people automatically qualify, such as those who:

• Receive full Medicaid benefits
• Are enrolled in a Medicare Savings Program (MSP) that pays your Medicare Part B premium
• Receive Supplemental Security Income (SSI)

Even if you don’t automatically qualify, you can apply separately through the Social Security Administration.

What Does Extra Help Cover?

If approved, Extra Help may reduce or eliminate:

• Part D monthly premiums
• Annual Part D deductibles.
• Co-pays for covered prescription drugs.

Many beneficiaries with Extra Help pay no more than a few dollars per prescription. Plus, you won’t pay the Part D late enrollment penalty if you qualify.

How to Apply

You can apply for Extra Help in one of several ways:

• Online at www.ssa.gov/extrahelp
• By phone at 1-800-772-1213 (TTY: 1-800-325-0778)
• In person at your local Social Security office

If you’re unsure whether you qualify, it’s still worth applying. Many people are surprised to find they’re eligible, especially those with limited savings or fixed incomes.

Need Help Navigating the Process?

You don’t have to figure it out alone. Your local State Health Insurance Assistance Program (SHIP) offers free, unbiased support. You can also reach out to us... we are happy to help!

The Bottom Line

Prescription drug costs shouldn’t be a barrier to getting the care you need. If you’re on Medicare and need help with drug costs, Extra Help can make a real difference. It’s easy to apply, and you could save hundreds—or even thousands—of dollars a year.

Want to see if you’re eligible or learn more about your Medicare options? Contact us today for guidance at (615) 249-1925.