Medicare Part D Low-Income Subsidy (LIS): Who May Qualify and How to Apply
The Medicare Part D Low-Income Subsidy (LIS) — commonly known as Extra Help — is a federal program administered by the Social Security Administration (SSA) that may help Medicare beneficiaries with limited income and resources pay for prescription drug costs under Medicare Part D. For people who are struggling to afford medications, this program may reduce or eliminate Part D premiums, annual deductibles, and per-prescription copayments. Benefit amounts vary by household size and income, but the SSA estimates the subsidy is worth up to approximately $5,900 per year in savings — though individual results will differ based on your specific plan and circumstances.
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What Is the Part D Low-Income Subsidy?
Medicare Part D covers outpatient prescription drugs, but standard plans come with premiums, deductibles, and cost-sharing that can be burdensome for people on fixed or limited incomes. The LIS program was created under the Medicare Modernization Act of 2003 to address this gap. It operates on a sliding scale: those with the lowest income and fewest resources may receive the full subsidy, while others may receive a partial subsidy that still meaningfully reduces out-of-pocket costs.
The program is distinct from Medicaid, though the two often interact. Some people are eligible for both Medicare and Medicaid (called "dual eligibles") and may receive the full LIS automatically.
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Income and Resource Limits: Who May Be Eligible?
Eligibility for Extra Help is determined by two factors: income and resources (assets). Both are evaluated by the SSA using thresholds that are updated annually.
Income Limits
To potentially qualify for the full or partial LIS benefit, your income generally must fall at or below 150% of the Federal Poverty Level (FPL). The SSA uses a broader definition of income than some other programs — it includes wages, Social Security benefits, pensions, and certain other sources. However, some income types, such as a portion of wages for working individuals, may be excluded from the calculation.
Resource Limits
In addition to income, the SSA evaluates countable resources, which include bank accounts, stocks, and bonds. Real estate (other than your primary home), a vehicle, personal belongings, and life insurance policies under certain values are typically excluded. Resource limits are adjusted periodically, so it is worth checking the current figures directly with the SSA or at Benefits.gov.
Automatic Enrollment: Who Gets LIS Without Applying?
Certain Medicare beneficiaries are automatically deemed eligible for the full LIS and do not need to submit a separate application. These include individuals who:
- Receive Medicaid (full benefit dual eligibles)
- Receive Supplemental Security Income (SSI) from the SSA
- Are enrolled in a Medicare Savings Program (MSP), such as the Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), or Qualifying Individual (QI) programs
If you fall into one of these categories, the SSA should notify you of your automatic enrollment. If you believe you qualify but have not received notice, contact the SSA directly at 1-800-772-1213 or visit your local Social Security office.
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How to Apply for Extra Help
Unlike Medicare's Annual Enrollment Period, there is no deadline to apply for Extra Help — you may apply at any time of year. This is an important distinction: if your financial situation changes, you can apply or reapply whenever it makes sense for you.
Where to Apply
There are three main pathways to apply:
- Social Security Administration (SSA): Apply online at ssa.gov, by phone at 1-800-772-1213, or in person at a local SSA office. The SSA's online application is available in English and Spanish.
- State Medicaid Agency: In some states, applying for Medicaid simultaneously screens you for LIS eligibility. Contact your state's Medicaid office directly.
- State Health Insurance Assistance Program (SHIP): Free, unbiased counseling is available through SHIP in every state. Counselors can help you understand your options and assist with the application process.
Required Documents
Gathering the following documents before you apply can help avoid delays:
- Proof of Medicare enrollment (your Medicare card or a letter from the SSA)
- Proof of income: Recent Social Security award letters, pension statements, or pay stubs
- Proof of resources: Bank statements, investment account statements (typically covering the past three months)
- Proof of residency: A utility bill, lease agreement, or similar document
- Social Security number
If you are applying on behalf of a spouse or dependent, you will need their documentation as well.
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What Benefits May LIS Provide?
For those who may qualify for the full subsidy, Extra Help may cover:
- The Part D monthly premium (up to the benchmark plan premium in your region)
- The annual Part D deductible
- Copayments reduced to a nominal amount per prescription (amounts vary and are updated annually by the Centers for Medicare & Medicaid Services)
For those who may qualify for a partial subsidy, the program may still reduce premiums and cost-sharing on a sliding scale based on income.
Benefit amounts vary by household size and income, and the specific savings depend on which Part D plan you are enrolled in.
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Other Prescription Assistance Programs to Know
If you do not meet LIS eligibility criteria, other programs may help reduce prescription costs:
- Medicare Savings Programs (MSPs): May help cover Medicare Part B premiums and other cost-sharing, and qualifying for an MSP automatically qualifies you for LIS.
- State Pharmaceutical Assistance Programs (SPAPs): Many states operate their own drug assistance programs that may work alongside or supplement LIS.
- Manufacturer Patient Assistance Programs (PAPs): Many pharmaceutical companies offer free or reduced-cost medications for people who meet income criteria. NeedyMeds (needymeds.org) and RxAssist (rxassist.org) maintain searchable databases.
- Federally Qualified Health Centers (FQHCs): These community health centers offer sliding-scale fee services and may have on-site pharmacy assistance or referral programs.
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A Note on Applying Through Online Forms
If you choose to submit your information through any online assistance form — including third-party benefit screening tools — please be aware that by submitting your contact information, you may be consenting to be contacted by phone, text, or email regarding program information. Review any consent language carefully before submitting.
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Program eligibility and availability vary by state. Not affiliated with any government agency.
Last reviewed: May 2026