Medicare Part D

Extra Help and Part D Drug Costs in Brighton

BRIGHTON, Colo. — If prescription costs make you flinch at the pharmacy counter, there's a federal program that could take a real weight off your shoulders. It's called Extra Help, also known as the Low-Income Subsidy (LIS), and it helps people with Medicare pay for their Part D prescription drug coverage.

Here's who qualifies in 2027, what the program covers, and how folks in Brighton can apply.

What Extra Help actually does

Extra Help is a federal benefit run by the Social Security Administration and Medicare. It helps pay for the costs tied to Part D drug plans, including:

• Monthly Part D plan premiums (up to a benchmark amount)
• The annual deductible
• Copays and coinsurance at the pharmacy

People who qualify for full Extra Help pay only small, capped amounts for covered generic and brand-name drugs. That matters even more in 2026, when Medicare's new $2,100 annual out-of-pocket cap on Part D drug costs kicks in — Extra Help can lower what you pay long before you ever hit that ceiling.

Who qualifies in 2027

To qualify for Extra Help, you must have Medicare and meet income and resource limits set each year by the federal government. As of 2024 changes signed into law, the program expanded so that everyone who qualifies now gets the full subsidy — the old "partial" tier is gone.

In general terms, you may qualify if:

• Your income is at or below 150% of the federal poverty level, and
• Your resources (things like money in checking, savings, stocks, and bonds) fall under the annual limit set by Social Security.

Your home, one car, burial plots, personal belongings, and life insurance policies don't count as resources. The exact dollar thresholds update every year, so check the current figures at Medicare.gov/extrahelp or with Social Security before assuming you don't qualify.

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

• Have full Medicaid coverage,
• Get help from a Medicare Savings Program, or
• Receive Supplemental Security Income (SSI).

Why it's worth applying — even if you're not sure

A lot of people who could get Extra Help never apply because they assume they make "too much" or have "too much saved." That's often wrong. The resource limits are more generous than people expect, and even middle-of-the-road retirees in Adams County can qualify.

Extra Help can also open the door to a Special Enrollment Period, meaning you don't have to wait for the fall Annual Enrollment Period (Oct. 15 – Dec. 7) to switch or join a Part D plan if your situation changes.

Brighton is in Adams County, where Medicare beneficiaries have a full slate of stand-alone Part D and Medicare Advantage plans with drug coverage to choose from during enrollment windows. Extra Help works alongside whichever Part D plan you pick.

How to apply

There are three straightforward ways to apply — all free:

1. Online at ssa.gov/medicare/part-d-extra-help. 2. By phone with Social Security at 1-800-772-1213 (TTY 1-800-325-0778). 3. In person at your local Social Security office.

You'll be asked about your income, household size, and resources. Have recent bank statements, Social Security award letters, and tax documents nearby — it makes the process quicker.

Colorado residents can also get free, unbiased help from the State Health Insurance Assistance Program (SHIP), which in Colorado is called the Senior Health Insurance Assistance Program. Counselors can walk you through the application at no cost and are not tied to any insurance company.

Deadlines to keep in mind

There's no single deadline to apply for Extra Help — you can apply anytime, year-round. But two Medicare dates matter for anyone using Part D:

• Annual Enrollment Period: Oct. 15 – Dec. 7 — for joining or changing a Part D or Medicare Advantage plan for the next year.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31 — for switching Medicare Advantage plans once a year.

If you get Extra Help mid-year, you'll usually get a Special Enrollment Period to pick or change plans without waiting.

A few other numbers to know for 2027

Even if you don't qualify for Extra Help, it's worth knowing the ground rules for Part D in 2027:

• Part D deductible: no plan can charge more than $700 in 2027 (the 2026 cap is $615).
• Out-of-pocket cap: once your covered drug costs hit $2,400 in 2027 ($2,100 in 2026), you pay nothing more for covered drugs the rest of the year.
• Medicare Prescription Payment Plan: lets you spread your drug costs across the calendar year in monthly bills instead of paying big amounts at the pharmacy.
• IRMAA: higher-income surcharges start above $109,000 in income for a single filer in 2026.

These figures come from Medicare Part D program rules at Medicare.gov.