Medicare Part D

Missing Extra Help? Kapolei retirees may leave drug aid on the table

KAPOLEI, Hawaii — If you have Medicare and worry about the cost of your prescriptions, there's a federal program that could quietly do a lot of the heavy lifting. It's called Extra Help, sometimes known as the Low-Income Subsidy, and it helps pay Part D premiums, deductibles, and copays. Many people who qualify never apply — often because they assume they earn too much or don't realize the program exists.

What Extra Help actually does

Extra Help is designed to make Part D — Medicare's prescription drug coverage — affordable for people living on tight budgets. If you qualify, the program can cover your Part D plan premium (up to a benchmark amount), wipe out your deductible, and cap what you pay at the pharmacy counter at a small set amount per prescription.

That works alongside the broader Part D rules from CMS. The annual out-of-pocket cap on covered drugs is $2,100 in 2026 and $2,400 in 2027, and the maximum deductible a plan can charge is $615 in 2026 and $700 in 2027. Extra Help sits on top of those protections and can bring costs down much further for people who qualify.

Who qualifies in 2027

Eligibility is based on two things: income and resources (savings and certain assets). The Social Security Administration updates the exact limits each year, but as a rough guide, single filers with incomes at or below 150% of the federal poverty level and modest savings generally qualify. Your home, your car, and personal belongings don't count toward the resource limit.

A big change took effect in 2024: Congress eliminated the partial Extra Help tier. Now, everyone who qualifies gets the full benefit. If you were denied or received partial help in years past, it's worth applying again.

You're automatically enrolled — no application needed — if you have:

• Full Medicaid coverage
• Supplemental Security Income (SSI)
• A Medicare Savings Program that pays your Part B premium

The mistakes that cost people the most

The most common mistake is assuming you don't qualify and never applying. Income limits are higher than many people expect, and the resource test doesn't count your house or car. Another mistake is confusing Extra Help with the Medicare Prescription Payment Plan — a separate 2025 option that lets you spread drug costs into monthly payments but does not reduce what you owe.

People also miss out by not reapplying after a life change. A drop in income, a spouse's death, or a move to a nursing facility can all shift your eligibility. And in Kapolei, some retirees skip applying because they own their home — but again, your primary residence doesn't count against you.

How to apply from Kapolei

You can apply for Extra Help any time of year — you do not have to wait for Medicare's Annual Enrollment Period (Oct. 15–Dec. 7) or the Medicare Advantage Open Enrollment Period (Jan. 1–March 31). There are three easy ways:

• Online at ssa.gov/extrahelp
• By phone at 1-800-772-1213 (Social Security)
• In person at your local Social Security office

Once Social Security approves you, Medicare will help match you with a Part D plan if you don't already have one. Kapolei is in Honolulu County, where there are multiple stand-alone Part D plans and Medicare Advantage plans with drug coverage available — meaning you'll have choices when picking a plan that works with Extra Help.

Free local help

If the paperwork feels overwhelming, you don't have to figure it out alone. Hawaii SHIP (the State Health Insurance Assistance Program) offers free, unbiased Medicare counseling, including help applying for Extra Help and comparing Part D plans. Counselors do not sell insurance and are not paid on commission.

You can also call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, or use the plan finder at medicare.gov.