Medicare Part D

Extra Help Could Cut Drug Costs in Naperville in 2026

NAPERVILLE, Ill. — For older adults and people with disabilities who feel squeezed by prescription costs, a federal program called Extra Help — also known as the Low-Income Subsidy, or LIS — can quietly do a lot of heavy lifting. It lowers what people pay for Medicare Part D drug coverage, and it works alongside an annual cap on out-of-pocket drug spending built into Part D itself — $2,100 in 2026 and $2,400 in 2027.

Yet many people who qualify for Extra Help never sign up. Here's a plain-English look at who qualifies, what it pays for, and how Naperville residents can apply.

What Extra Help Actually Does

Extra Help is a federal benefit run by the Social Security Administration and Medicare. It helps pay the premium, deductible, and copays that come with a Medicare Part D prescription drug plan.

People who qualify for the full benefit typically pay only small, capped amounts for covered generic and brand-name drugs. They also skip the Part D deductible — set at a maximum of $615 in 2026 and $700 in 2027 — and don't pay a Part D premium up to a benchmark amount set by Medicare each year.

Extra Help works with the broader Part D program, including the redesigned three-phase structure that took effect in 2025 (the old "donut hole" coverage gap is gone) and the out-of-pocket cap, which is $2,100 in 2026 and $2,400 in 2027.

Who Qualifies in 2027

Extra Help is based on income and resources, not health status. Congress expanded the program in 2024 so that everyone who qualifies now gets the full subsidy — the older "partial" tier is no longer separate.

To qualify, you generally need to:

• Have Medicare Part A and/or Part B.
• Live in one of the 50 states or Washington, D.C.
• Fall under the income limit — roughly 150% of the federal poverty level. For 2025 applications, that's about $23,475 a year for an individual and $31,725 for a married couple living together. Limits typically rise slightly each year.
• Have resources (savings, investments, and similar assets) under the program's limit — around $17,600 for an individual and $35,130 for a couple in 2025. Your home, car, and personal belongings don't count.

You may also qualify automatically if you have Medicaid, get Supplemental Security Income (SSI), or are in a Medicare Savings Program. In those cases, you don't need to apply — you're "deemed" eligible and Medicare will send a letter.

Why Naperville Residents Should Take a Second Look

Naperville is in DuPage County, where a wide range of stand-alone Part D drug plans and Medicare Advantage plans with drug coverage is available during Medicare's Annual Enrollment Period. Choice is good — but it can also make it hard to know what you're paying for and whether you're leaving help on the table.

Extra Help is one of the most under-used benefits in Medicare. The Social Security Administration has estimated that millions of people who qualify haven't applied, often because they assume their income is "too high" or they don't want to fill out another form. If your income is close to the limit, it's worth checking anyway — Social Security decides, not a guess at the kitchen table.

How to Apply

There is no cost to apply, and you can do it three ways:

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

You'll need basic information about your income, savings, and any investments. Social Security will send a decision letter. If you're approved, you can then join a Part D plan — or switch plans — using a special enrollment period tied to Extra Help.

For free, one-on-one help in Naperville, contact Illinois SHIP (the state's Senior Health Insurance Program) at 1-800-252-8966. SHIP counselors don't sell anything and can walk you through the application and your Part D options.

How Extra Help Fits With Other 2027 Changes

Even if you don't qualify for Extra Help, Part D itself continues to evolve in 2027:

• The out-of-pocket cap limits what any enrollee pays for covered drugs in a calendar year — $2,100 in 2026 and $2,400 in 2027.
• The Medicare Prescription Payment Plan lets you spread your drug costs across monthly payments rather than paying large amounts at the pharmacy counter. It's optional and free to opt into.
• IRMAA — the income-related surcharge on Part B and Part D premiums — kicks in above $109,000 for a single filer in 2026. That's a separate calculation from Extra Help.

Key Deadlines to Remember

• Extra Help: You can apply any time of year — there's no deadline.
• Medicare Annual Enrollment Period: Oct. 15 – Dec. 7, when anyone can join, switch, or drop a Part D or Medicare Advantage plan.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31, for people already in a Medicare Advantage plan who want to change once.