Medicare Part D
Part D Extra Help subsidy explained for Orlando retirees
ORLANDO, Fla. — If paying for prescriptions each month feels tighter than it used to, you're not alone. Many Central Florida retirees are surprised to learn there's a federal program that can quietly take a big bite out of their drug bill — and a lot of people who qualify never sign up.
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Click to call 855-729-3240Key takeaways
- Extra Help, also called the Low-Income Subsidy, is a federal program that can lower or even erase your Medicare Part D premium and deductible and caps what you pay for prescriptions at the pharmacy.
- You still need a separate Part D or Medicare Advantage drug plan, since Extra Help just reduces your costs inside that plan, not replaces it.
- People already on Medicaid, SSI, or a Medicare Savings Program get Extra Help automatically, while others can apply for free through Social Security online, by phone, or in person.
- If you qualify for Extra Help, you can switch drug plans more often than the usual enrollment windows, and combining it with the 2027 $2,400 drug cost cap can make your prescription costs more predictable.
It's called Extra Help, sometimes known as the Low-Income Subsidy (LIS). Here's a plain-English look at how it works for 2027, who qualifies, and how to apply from Orlando.
What Extra Help actually does
Extra Help is a federal program run through Social Security and Medicare that assists people with limited income and resources in paying for Medicare Part D prescription drug coverage. It can lower or eliminate your Part D premium and deductible, and it caps what you pay for covered prescriptions at the pharmacy.
Extra Help is not a separate insurance plan. You still enroll in a Medicare Part D plan (or a Medicare Advantage plan that includes drug coverage). Extra Help simply reduces what you pay out of pocket inside that plan.
Who qualifies in 2027
To qualify, you must:
- Have Medicare (Part A, Part B, or both).
- Live in one of the 50 states or D.C.
- Meet income and resource limits set by the federal government.
Income and resource limits are adjusted each year and are checked when you apply. As a rule of thumb, you may qualify if your income is at or near 150% of the federal poverty level, and your savings and investments fall under a set limit. Your home, your car, and personal belongings usually don't count.
If you already have Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program, you're automatically enrolled in Extra Help — you don't need to apply.
Why it matters even more in 2027
Part D is going through a major overhaul. A few program-level facts every Orlando reader should know:
- Out-of-pocket cap: In 2026, your annual out-of-pocket costs for covered Part D drugs are capped at $2,100. Once you hit it, you pay $0 for the rest of the calendar year for covered prescriptions.
- Maximum Part D deductible: $615 in 2026 (plans can set theirs lower).
- No more "donut hole": As of 2025, the coverage gap phase was eliminated. Part D now has three phases instead of four.
- Medicare Prescription Payment Plan: You can choose to spread your drug costs across the calendar year in monthly payments instead of paying big bills at the pharmacy counter. This is separate from Extra Help, and you can use both.
Extra Help lowers your costs within this structure — so combining Extra Help with the $2,400 cap in 2027 can make prescriptions much more predictable.
What plan choices look like in Orlando
Orlando is in Orange County, Florida, where Medicare beneficiaries typically have a wide range of stand-alone Part D plans and Medicare Advantage plans with drug coverage to choose from. Availability and plan details are set at the county level, not the city level, so two neighbors in the same ZIP code generally see the same options.
If you qualify for Extra Help, you can switch Part D or Medicare Advantage drug plans more often than most people — you're not locked to just the Annual Enrollment Period (Oct. 15 – Dec. 7) or Medicare Advantage Open Enrollment (Jan. 1 – March 31).
How to apply
There's no fee to apply, and applying doesn't obligate you to anything.
1. Online: Go to ssa.gov/extrahelp and complete the Social Security application. 2. By phone: Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). 3. In person: Visit a Social Security office. There are several serving the Orlando area. 4. Free local help: Florida's SHINE program (Florida's SHIP) offers free, unbiased Medicare counseling. Call the Elder Helpline at 1-800-963-5337.
Have this handy when you apply: Social Security numbers for you and your spouse, bank statements, investment records, and information about any income and pensions.
A quick note on IRMAA
Extra Help is for people with limited income. On the opposite end, higher-income beneficiaries pay a surcharge called IRMAA on top of Part B and Part D premiums. In 2026, IRMAA begins for single filers with income above $109,000. It has nothing to do with Extra Help, but it's worth knowing which side of the ledger you're on.
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 Orange County
(MA penetration in Orange 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
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.
Explore
When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
Good to know
Frequently asked questions
Q: I was denied Extra Help a few years ago. Should I try again?
Q: If I get Extra Help, do I still need to pick a Part D plan?
Q: Does Extra Help affect the $2,100 out-of-pocket cap?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.