Medicare Part D

Port Orange Medicare readers: how to tell if you qualify for Extra Help on Part D

PORT ORANGE, Fla. — If paying for prescriptions each month feels like a stretch, there is a federal program you should know about. It is called Extra Help, and it can lower what people with Medicare pay for their Part D drug plan and their medicines at the pharmacy.

Extra Help — also known as the Low-Income Subsidy, or LIS — is run by Social Security and Medicare. In 2025, the program expanded so that more people with modest incomes qualify for the full benefit. Those rules carry into 2026 and 2027, and you can apply any time of year.

Port Orange is in Volusia County, where residents have several Part D and Medicare Advantage drug plans to choose from during Medicare's Annual Enrollment Period, which runs Oct. 15 through Dec. 7. Extra Help works alongside those plans.

What Extra Help actually pays for

Extra Help is tied to Medicare Part D, the part of Medicare that covers prescription drugs. If you qualify, the program can help with:

• Your monthly Part D plan premium (up to a benchmark amount set by Medicare)
• Your yearly Part D deductible
• Your copays or coinsurance at the pharmacy

According to CMS, people who get the full Low-Income Subsidy pay no more than a few dollars for each covered generic or brand-name prescription. Extra Help does not pay for over-the-counter medicines or for drugs your plan does not cover.

Who qualifies for Extra Help

To qualify for Extra Help, you must have Medicare Part A and/or Part B, live in the United States, and fall within the program's income and resource limits.

As of the 2025 expansion that carries forward, the full Extra Help benefit is available to people with incomes up to 150% of the federal poverty level, with resource limits set by Social Security. Resources include things like money in checking and savings accounts and stocks or bonds — they do not include your home, one car, personal belongings, or a burial plot.

You do not have to guess. Social Security will review your application and tell you whether you qualify. The current income and resource limits are posted at ssa.gov/extrahelp.

You may already have it — and not know

Some people are enrolled in Extra Help automatically. You get it without applying if you have Medicare and any one of these:

• Full Medicaid coverage
• Help from a state Medicare Savings Program paying your Part B premium
• Supplemental Security Income (SSI) benefits from Social Security

If you fall into one of those categories, Medicare mails you a letter letting you know. If you are not sure, call 1-800-MEDICARE (1-800-633-4227) and ask them to check your status.

How to apply

Applying is free, and you can do it three ways:

1. Online at ssa.gov/extrahelp 2. By phone at 1-800-772-1213 (TTY 1-800-325-0778) 3. In person at a local Social Security office

The application is short and asks about your income, your household, and your resources. You do not need to send in bank statements or pay stubs to apply — Social Security may ask for documents later.

If you are approved, you will still need to be enrolled in a Part D plan for Extra Help to lower your drug costs. If you don't have one, Medicare can help you pick one.

How Extra Help fits with Part D changes for 2027

Part D looks different than it did a few years ago. The coverage gap — often called the "donut hole" — was eliminated in 2025. The annual out-of-pocket limit for covered drugs is $2,100 in 2026 and $2,400 in 2027, and the maximum plan deductible is $615 in 2026 and $700 in 2027.

There is also a payment option called the Medicare Prescription Payment Plan, which lets you spread your yearly drug costs across monthly payments instead of paying big amounts at the pharmacy. It does not lower your total cost, but it can make bills easier to manage. Extra Help, by contrast, actually reduces what you owe.

Where Port Orange residents can get free help

You do not have to figure this out alone. Florida's SHINE program (Serving Health Insurance Needs of Elders) is the state's SHIP — its free, unbiased Medicare counseling service. SHINE counselors can walk you through an Extra Help application and review your Part D options at no cost. You can reach SHINE through the Florida Department of Elder Affairs or by calling the Elder Helpline at 1-800-963-5337.