Medicare Advantage

Extra Help in Spokane: paying for Medicare Part D

People in Spokane can choose from 47 Medicare Advantage plans for 2027, against 59 this year. 21 of this year’s plans are gone, 9 are new to Spokane County, and 28 that continue have changed their premium, deductible, plan type or name, 10 of them under a new name.

SPOKANE, Wash. — If prescription costs make you nervous, there's a federal program that could quietly do a lot of the heavy lifting. It's called Extra Help, sometimes known as the Low-Income Subsidy (LIS). It helps people with limited income and resources pay for Medicare Part D — the part of Medicare that covers prescription drugs.

Spokane seniors: Extra Help can ease drug costs in 2027

Spokane is in Spokane County, where Medicare drug plan availability is set at the county level. But Extra Help itself is a national program, and the rules are the same whether you live on the South Hill, in Hillyard, or out toward Airway Heights.

What Extra Help actually does

Extra Help lowers what you pay for Part D. Depending on your situation, it can reduce or eliminate your monthly drug plan premium and deductible, and it caps what you pay at the pharmacy counter for covered generic and brand-name drugs.

It also removes the late enrollment penalty for Part D if you qualify. That's a big deal for people who delayed signing up and worried they'd be stuck with a lifetime penalty.

Extra Help works alongside the broader Part D changes taking effect in 2027:

• A Part D out-of-pocket cap of $2,100 in 2026 and $2,400 in 2027 on covered drugs.
• A maximum Part D deductible of $615 in 2026 and $700 in 2027 (many plans set it lower).
• The old coverage gap — the "donut hole" — has been eliminated since 2025, leaving three simpler payment phases.
• The Medicare Prescription Payment Plan, which lets you spread your drug costs into monthly installments instead of paying big amounts all at once.

Even people who don't qualify for Extra Help benefit from these changes. But for those who do qualify, the savings stack on top.

Who qualifies in 2027

Extra Help uses two tests: income and resources (things like money in the bank, stocks, and bonds — your home, car, and personal belongings don't count).

As of 2024, Congress expanded Extra Help so there is no longer a "partial" benefit — if you qualify, you get the full subsidy. Income limits are tied to the federal poverty level and adjust each year, so the exact 2027 numbers are posted on medicare.gov.

You may automatically get Extra Help if you:

• Have both Medicare and full Medicaid (in Washington, that's Apple Health),
• Get help from a Medicare Savings Program, or
• Receive Supplemental Security Income (SSI).

If you're not auto-enrolled, you can still apply — and many people who qualify never do, simply because no one told them to try.

How to apply from Spokane

There are three straightforward ways:

1. Online through the Social Security Administration at ssa.gov/extrahelp. 2. By phone at 1-800-772-1213 (Social Security) or 1-800-MEDICARE (1-800-633-4227). 3. In person with free help from Washington's SHIBA program (Statewide Health Insurance Benefits Advisors) — that's Washington's SHIP. SHIBA counselors are trained volunteers who don't sell anything. They can sit with you, review your paperwork, and walk you through the application. You can reach SHIBA at 1-800-562-6900 or through the Washington State Office of the Insurance Commissioner's website.

You can apply any time of year. You do not have to wait for a Medicare enrollment window.

What happens after you're approved

If you're approved for Extra Help, Medicare will help you choose a Part D drug plan if you don't already have one. You'll also get a Special Enrollment Period, which means you can change your drug plan outside the normal Annual Enrollment Period (Oct. 15 – Dec. 7).

Keep an eye on the mail. Social Security may send a letter asking you to confirm your income and resources every so often — usually late summer — to make sure your subsidy continues. Don't ignore it.

A quick word on IRMAA — the other side of the coin

Extra Help is for people with lower incomes. On the higher end, Medicare charges an extra amount called IRMAA (Income-Related Monthly Adjustment Amount) for Part B and Part D. In 2026, IRMAA surcharges start above $109,000 in income for a single filer. Most people don't hit that, but it's worth knowing the system works in both directions.