Medicare 2026

Extra Help With Part D Drug Costs in 2027: Who Qualifies and How to Apply

Prescription drugs can be one of the biggest worries when you first look at Medicare. The good news is that a federal program called Extra Help — also known as the Part D Low-Income Subsidy, or LIS — can significantly lower what you pay for your Medicare prescription drug coverage. Here is a plain-English guide to how Extra Help works in 2027, who may qualify, and how to apply.

What Extra Help actually does

Extra Help is a federal program that pays a large portion of your Medicare prescription drug costs. If you qualify, it can:

• Pay all or part of your monthly Part D plan premium (up to a benchmark amount set each year).
• Reduce or eliminate your Part D deductible. For reference, in 2027 no Part D plan may charge a deductible higher than $700, and people with full Extra Help generally pay no deductible at all.
• Lower your copays at the pharmacy to small, fixed amounts for covered generic and brand-name drugs.
• Eliminate the Part D late-enrollment penalty while you qualify. (The penalty for others is calculated using the 2027 national base beneficiary premium of $41.33.)

Extra Help also works alongside the new Part D out-of-pocket maximum. In 2027, no one with Part D coverage will pay more than $2,400 out of pocket for covered prescriptions in a calendar year. With Extra Help, most people reach much lower totals than that, because their copays are capped at modest amounts from the start.

Who qualifies in 2027

Extra Help is based on your income and your resources (things like money in checking, savings, stocks, and bonds). The Social Security Administration updates the income and resource limits each year, usually tied to the federal poverty level and cost-of-living changes. (SSA announced a 3.6 percent COLA for benefits payable beginning January 2027, which also affects the figures used in need-based programs.)

A few important points:

• Starting in 2024, Congress expanded Extra Help so that everyone who qualifies now gets the full subsidy. There is no longer a "partial" Extra Help tier.
• Not everything counts as a resource. Your home, one vehicle, personal belongings, and certain burial funds are generally excluded.
• Some income does not count either, such as certain assistance you receive from others for household expenses.

Because the exact dollar limits change each year, check the current numbers at Medicare.gov or SSA.gov before assuming you do or do not qualify. Many people who could get Extra Help never apply because they assume their income is too high.

Automatic qualification

You do not need to apply for Extra Help if you already have any of the following, because you qualify automatically:

• Full Medicaid coverage.
• A Medicare Savings Program (which helps pay Part B costs) through your state.
• Supplemental Security Income (SSI) benefits.

If you fall into one of these groups, Medicare will mail you a notice confirming your Extra Help status, and you will be enrolled in a Part D plan if you are not already in one. You can switch to a different Part D plan if the one you are auto-enrolled in does not fit your needs.

How to apply

If you are not automatically enrolled, applying is free and relatively simple. You can:

1. Apply online through the Social Security Administration at ssa.gov. 2. Call Social Security at 1-800-772-1213. 3. Apply in person at a Social Security office. 4. Apply through your state Medicaid office, which may also screen you for other assistance.

You will be asked about your household income, your resources, and your living situation. Keep bank statements, pension or Social Security award letters, and investment account summaries handy. There is no cost to apply, and you do not need to hire anyone to help you.

Once SSA approves you, they will send a letter explaining your subsidy. You can then join a Part D plan during any valid enrollment period — and if you already have one, your costs will drop automatically.

Changing plans with Extra Help or Medicaid

Since 2025, people who have Medicaid or Extra Help have a monthly Special Enrollment Period that lets them switch to Original Medicare paired with a stand-alone Part D plan, or move between stand-alone Part D plans. If you are a full-benefit dual-eligible (meaning you have both Medicare and full Medicaid), you can also join an integrated Dual Eligible Special Needs Plan (D-SNP) in any month that one is available to you.

This flexibility is helpful if your medications change, if a plan drops a drug from its formulary, or if your pharmacy stops being in-network.

How this fits with your bigger Medicare choices

Extra Help only affects your Part D drug coverage. You still have to decide how to get the rest of your Medicare:

• Original Medicare (Parts A and B), often paired with a stand-alone Part D plan and sometimes a Medigap policy. This path typically offers broad provider access nationwide and predictable supplemental coverage, but may involve additional premiums.
• A Medicare Advantage plan (Part C), which usually includes drug coverage. These plans often bundle extras and may have lower monthly costs, but typically use provider networks and prior authorization.

Neither path is "better" — the right fit depends on your doctors, your medications, your budget, and how you like to receive care. The 2027 Part B standard premium and deductible, and the IRMAA income-related surcharges, had not yet been announced at the time of writing; CMS typically releases them in the fall. Check Medicare.gov for the current figures before you decide.

Annual Enrollment for 2027 coverage runs October 15 – December 7, 2026, with changes taking effect January 1, 2027.

Where can you get help with Medicare questions?

For official, up-to-date information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, 7 days a week. For Extra Help specifically, you can also contact the Social Security Administration at ssa.gov or 1-800-772-1213.