Medicare Part D

Medicare Part D Extra Help in Sun City: Who Qualifies

SUN CITY, Ariz. — For many older adults on a fixed income, the cost of prescription drugs is one of the biggest worries about getting older. A federal program called Extra Help — sometimes called the Low-Income Subsidy, or LIS — is designed to ease that burden by lowering what people with Medicare pay for their Part D prescription drugs. And in 2027, more people than ever may qualify.

Here in Sun City, where a large share of residents rely on Medicare, understanding who qualifies for Extra Help — and how to apply — can make a real difference at the pharmacy counter.

What Extra Help actually does

Extra Help pays for a big share of your Part D drug plan costs. People who qualify pay little or nothing for their monthly Part D premium and deductible, and they pay much smaller, set amounts for covered generic and brand-name drugs at the pharmacy.

According to the Centers for Medicare & Medicaid Services (CMS), Extra Help is worth thousands of dollars a year in reduced drug costs for people who qualify. The exact amount depends on your income, your household size, and the drugs you take.

Extra Help is separate from Medicare itself. You still need to be enrolled in a Medicare Part D prescription drug plan (either a stand-alone plan or one built into a Medicare Advantage plan) to use the benefit.

Who qualifies in 2027

To qualify for Extra Help, you must have Medicare and meet limits on both income and resources. Social Security updates these limits each year.

In general terms, Extra Help is aimed at people whose income is at or below 150% of the federal poverty level, with modest savings and assets. Your home, one car, burial plots, and personal belongings do not count toward the resource limit.

You automatically get Extra Help — no application needed — if you already have:

• Full Medicaid coverage,
• A state program that pays your Medicare Part B premium (a Medicare Savings Program), or
• Supplemental Security Income (SSI) benefits from Social Security.

If any of those apply, Medicare mails you a notice. If you're not sure whether it applies to you, it's worth checking anyway.

What changed recently

Under the Inflation Reduction Act, Extra Help was expanded in 2024 so that everyone who qualifies now gets the full benefit. Before that, some people with slightly higher incomes were placed in a "partial" Extra Help category and still had higher copays. That partial tier is gone.

That change matters in a place like Sun City, where retirees on Social Security may be right around the qualifying line. If you were told years ago that you didn't qualify, or that you only qualified for a smaller benefit, it is worth applying again under the current rules.

How Extra Help fits with 2027 Part D changes

Even people who don't qualify for Extra Help will see meaningful Part D changes in 2027:

• The annual out-of-pocket cap for covered Part D drugs is $2,100 in 2026 and $2,400 in 2027. Once you reach that amount in a calendar year, you pay $0 for covered drugs for the rest of the year.
• The Part D deductible can be no higher than $615 in 2026 and $700 in 2027.
• The old "donut hole" coverage gap was eliminated in 2025. Part D now has three simpler phases.
• The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs into monthly payments across the year instead of paying big amounts all at once at the pharmacy.

If you qualify for Extra Help, your costs are already far below that cap. If you don't qualify, the cap and the monthly payment option are still meaningful protections.

Local context: plan choices in Maricopa County

Sun City is in Maricopa County, where Medicare beneficiaries have a wide range of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage. Plan availability and details are set at the county level, not the city level. The plan finder at medicare.gov lets you enter your ZIP code and your prescription list to compare plans side by side — and it will flag whether you qualify for Extra Help pricing.

You do not have to wait for the Annual Enrollment Period (Oct. 15 – Dec. 7) to apply for Extra Help. You can apply for the subsidy any time. If your Extra Help status changes, you also get a Special Enrollment Period to change your drug plan.

How to apply

Applying for Extra Help is free, and you can do it in any of these ways:

• Online at ssa.gov/extrahelp
• By phone at 1-800-772-1213 (TTY 1-800-325-0778)
• In person at your local Social Security office
• With help from your State Health Insurance Assistance Program (SHIP). In Arizona, SHIP counselors offer free, unbiased, one-on-one help.

Have a rough idea of your income, savings, and any investments handy. You do not need perfect paperwork to start the application.