LOW INCOME SUBSIDY (LIS)

You may be able to get Extra Help from the government for your Medicare Advantage plan with prescription drug coverage.

You may be eligible for help paying for some or all of your prescription drug costs, based on guidelines set by the federal government. You can apply for this help through the Social Security Administration or a state Medical Assistance Office. The amount of assistance you receive, if any, will depend on your income and resources, and is determined by the federal government.

If you aren't getting Extra Help, you can see if you qualify for Extra Help to pay for your prescription drug costs. If eligible, Medicare could pay for up to one-hundred (100) percent of drug costs including monthly prescription drug premiums, annual deductibles, and coinsurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don't know it.

To see if you qualify for Extra Help, call: (800) 633-4227. TTY users should call (877) 486-2048, 24 hours a day, 7 days a week; the Social Security Office at (800) 772-1213 between 7:00AM and 7:00PM, Monday through Friday. TTY users should call (800) 325-0778; or your state Medicaid office.

For the Medicare program's policy on evidence of eligibility for low income subsidy, visit the CMS website's Best Available Evidence page.

2026 Premium Subsidy Tables for Those Who Qualify for Extra Help

If you know you qualify or are already receiving help to pay for your Medicare prescription drug plan, learn how much you will pay for your monthly premium as a member of a Medicare Advantage plan. The premiums listed in the table below include coverage for both medical services and prescription drug coverage. 

* This does not include any Medicare Part B premium you may have to pay.

Extra Help with Medicare Prescription Drug Costs

Save Money on Your Prescription Medication

If you have limited income and resources, you may qualify for Extra Help, a federal program that helps pay Medicare prescription drug costs. Many Medicare beneficiaries are eligible for this assistance and may not realize it.

Extra Help can significantly reduce your out-of-pocket prescription drug expenses and may help pay for:

• Monthly Medicare Part D premiums

• Annual prescription drug deductibles

• Prescription copayments and coinsurance

• Other Medicare prescription drug costs

Depending on your eligibility, the program may cover most or all of your prescription drug expenses.

Who May Qualify for Extra Help?

You may qualify for Medicare’s Extra Help program if you:

• Have Medicare coverage. 

• Have limited income and financial resources.

• Receive certain assistance programs, such as :

  • Full Medicaid benefits.

  • A Medicare Savings Program (MSP)

  • Supplemental Security Income (SSI).

Individuals who receive Medicaid, participate in a Medicare Savings program, or receive SSI are generally enrolled in Extra help automatically. Others may qualify by applying through the Social Security Administration.

Eligibility for Extra Help is determined by the federal government and is based on factors such as:

• Income

• Financial Resources

• Medicaid eligibility

• Other qualifying assistance programs

Even if you have applied in the past or were previously denied, it may be worth checking again, as eligibility guidelines can change.

Why Apply?

Receiving Extra Help can make prescription medications more affordable and help you maintain access to the medications you need. In addition, members who qualify may receive protection from certain Medicare Part D penalties and other prescription drug costs.

How to Apply

You can apply for Extra Help through:

• Medicare: Call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.

• Social Security Administration: Call 1-800-772-1213, Monday through Friday, 7:00 a.m. to 7:00 p.m. TTY users should call 1-800-325-0778.

Need Help?

GlobalHealth is here to support you. If you have questions about your Medicare plan benefits or need assistance understanding available financial assistance programs, please contact Member Services.

2027 Premium Subsidy Tables for Those Who Qualify for Extra Help

If you know you qualify or are already receiving help to pay for your Medicare prescription drug plan, learn how much you will pay for your monthly premium as a member of a Medicare Advantage plan. The premiums listed in the table below include coverage for both medical services and prescription drug coverage.

* This does not include any Medicare Part B premium you may have to pay.