Medicare Part D

Medicare Part D Extra Help for Birmingham residents

In Birmingham, many people on Medicare are quietly paying more for prescriptions than they need to. A federal program called Extra Help — also known as the Low-Income Subsidy, or LIS — can dramatically lower what you owe for Part D drug coverage, but only if you apply. And with 2027 bringing further Part D changes, this is a good moment to check whether you qualify.

What Extra Help actually does

Extra Help is a federal benefit run by the Social Security Administration and Medicare. If you qualify, it pays most of the cost of your Medicare Part D prescription drug plan. That means a lower — or zero — monthly premium, no or reduced deductible, and small, fixed copays for covered drugs at the pharmacy.

For people living on a fixed income, the difference can be significant. Extra Help is not a separate insurance plan. You still enroll in a Part D plan (or a Medicare Advantage plan that includes drug coverage), and the subsidy attaches to it.

Who qualifies in 2027

Extra Help has two tests: income and resources.

• Income: In 2024, Social Security expanded full Extra Help to everyone with income at or below 150% of the federal poverty level. The 2027 limits will be updated by Social Security, so check current figures when you apply.
• Resources: This includes things like money in checking and savings accounts, stocks, and bonds. It does not count your home, one car, personal belongings, or burial plots.

Some people are automatically enrolled in Extra Help and do not need to apply. That includes people who have both Medicare and full Medicaid, people enrolled in a Medicare Savings Program, and people who get Supplemental Security Income (SSI). If that describes you, Medicare will send a letter confirming your status.

How Extra Help fits with 2027 Part D changes

The Part D program was redesigned starting in 2025, and the changes continue into 2027. The old "donut hole" coverage gap is gone, replaced by a simpler three-phase design. Key figures:

• The maximum Part D deductible is $615 in 2026 and $700 in 2027.
• The annual out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. Once you hit it, you pay nothing for covered drugs the rest of the year.
• There is also a Medicare Prescription Payment Plan that lets you spread your drug costs across the year in monthly installments instead of paying big bills at the counter.

Extra Help stacks on top of these protections. If you qualify, your out-of-pocket costs are typically much lower than the cap, and you may have no deductible at all.

Plan choices in the Birmingham area

Birmingham is in Jefferson County, where multiple stand-alone Part D plans and Medicare Advantage plans with drug coverage are offered each year. Availability and plan details are set at the county level, so two neighbors on the same street generally see the same list of options. During the Annual Enrollment Period (October 15 – December 7), you can compare those plans on medicare.gov using the Plan Finder tool, which will also show how Extra Help changes your costs if you qualify.

How to apply

There are three easy ways to apply for Extra Help, and all are free:

1. Online at ssa.gov/extrahelp. 2. By phone at 1-800-772-1213 (Social Security). 3. In person at your local Social Security office.

You can also get one-on-one help from Alabama's State Health Insurance Assistance Program (SHIP), which offers free, unbiased Medicare counseling. In Alabama, SHIP is run through the Alabama Department of Senior Services.

Watch for a few common tripwires: don't assume you make "too much" — the limits are higher than many people think — and don't wait for enrollment season. You can apply for Extra Help any time of the year.