Medicare Part D
Extra Help Can Cut Drug Costs for Bonita Springs Seniors
BONITA SPRINGS, Fla. — If prescription costs are stretching your budget, there's a federal program you may be overlooking. It's called Extra Help, sometimes known as the Low-Income Subsidy (LIS), and it's designed to make Medicare Part D drug coverage more affordable for people with limited income and savings.
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Key takeaways
- Extra Help, also called the Low-Income Subsidy (LIS), is a federal program that can lower Part D premiums, deductibles, and drug costs for people with limited income and savings.
- As of 2024, everyone who qualifies gets the full subsidy, since the old "partial" Extra Help category no longer exists.
- Starting in 2026, Part D had a $2,100 yearly out-of-pocket cap and a maximum deductible of $615; in 2027 the cap is $2,400 and the maximum deductible is $700. The coverage gap ("donut hole") was already eliminated in 2025.
- Some people are automatically enrolled in Extra Help, and anyone approved can enroll in or switch a Part D plan outside the usual enrollment windows.
A quieter way to lower prescription costs in Bonita Springs
Bonita Springs is in Lee County, where thousands of Medicare beneficiaries fill prescriptions each month. For those who qualify, Extra Help can significantly reduce what they pay at the pharmacy counter — including monthly Part D premiums, deductibles, and the cost of covered drugs.
What Extra Help actually does
Extra Help is a federal benefit run through the Social Security Administration and Medicare. If you qualify, it helps pay:
- Your Part D monthly premium (up to a set benchmark amount)
- Your Part D deductible
- Your copays for covered prescription drugs
As of 2024, Congress expanded Extra Help so that everyone who qualifies now gets the full subsidy. The old "partial" Extra Help category is gone. That's a meaningful change — more people get the maximum benefit than before.
Extra Help also works alongside the rest of Medicare's newer drug rules. The Part D annual out-of-pocket cap for covered drugs is $2,100 in 2026 and $2,400 in 2027. The maximum Part D deductible is $615 in 2026 and $700 in 2027. The coverage gap — the old "donut hole" — was eliminated in 2025. Extra Help sits on top of those protections for people who qualify.
Who qualifies in 2026 and 2027
Extra Help is based on two things: income and resources (savings and certain assets).
For 2025, you generally qualify if:
- Your annual income is at or below 150% of the federal poverty level (roughly $23,475 for a single person and $31,725 for a married couple living together — slightly higher in Alaska and Hawaii), and
- Your resources are at or below about $17,600 for an individual or $35,130 for a married couple in 2025.
Resources include things like money in checking and savings accounts, stocks, and bonds. They do not include your home, your car, personal belongings, burial plots, or life insurance.
These numbers are updated each year, so the 2026 and 2027 limits will be slightly different. Don't rule yourself out based on a rough guess — apply and let Social Security do the math.
You may already be getting it automatically
Some people get Extra Help without applying. You're automatically enrolled if you:
- Have both Medicare and full Medicaid
- Get help from your state paying Medicare premiums (a Medicare Savings Program)
- Receive Supplemental Security Income (SSI)
If that's you, you should receive a letter from Medicare confirming your Extra Help status. If you think you should qualify automatically but haven't heard anything, it's worth a phone call.
How to apply from Bonita Springs
Applying is free, and it doesn't obligate you to change any of your current coverage.
- Online: ssa.gov/extrahelp
- By phone: Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778)
- In person: Visit your local Social Security office
- Free local help: Florida's SHINE program (the state's SHIP) offers free, unbiased Medicare counseling. Call the SHINE helpline at 1-800-963-5337 to speak with a trained volunteer, many of whom serve Southwest Florida communities including Bonita Springs.
If you're approved, you can enroll in or switch a Part D plan outside the usual enrollment windows — Extra Help gives you special enrollment opportunities throughout the year.
Other tools that work with Extra Help
Even if you don't qualify for Extra Help, keep these in mind:
- The Medicare Prescription Payment Plan (new as of 2025) lets you spread your out-of-pocket drug costs across the calendar year in monthly payments instead of paying large amounts at once. You can opt in through your Part D plan.
- The Annual Enrollment Period runs October 15 to December 7 each year — the main window to review and change Part D or Medicare Advantage coverage.
- Medicare Advantage Open Enrollment runs January 1 to March 31 for people already in a Medicare Advantage plan.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Lee County
(MA penetration in Lee County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Try it
Find your 2026 Medicare premium
Most people pay the standard Part B premium. If your 2024 income was higher, an income-related surcharge (IRMAA) applies. Enter your details to see your bracket.
Surcharges are added to your premiums and based on your 2024 tax return. Married-filing-separately uses a different schedule. Confirm at Medicare.gov.
Try it
How the 2026 Part D drug cap works
Slide to your estimated yearly prescription costs and see how the new $2,100 out-of-pocket cap protects you. This illustrates the standard Part D benefit; your plan may structure costs differently.
Once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for the rest of 2026. Confirm details at Medicare.gov.
Good to know
Frequently asked questions
Do I have to be on Medicaid to get Extra Help?
Will applying affect my Social Security or other benefits?
I was denied Extra Help years ago. Should I try again?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.