Medicare Part D

Extra Help: a Medicare Part D subsidy in Schererville

Schererville, Ind. — If prescription costs are stretching your budget, there's a federal program that may quietly do more for you than any plan switch could. It's called Extra Help, also known as the Low-Income Subsidy (LIS), and it's designed to lower what people with Medicare pay for their Part D prescription drugs.

Heading into 2027, Extra Help matters more than ever. Medicare Part D has a hard cap on what any enrollee pays out of pocket for covered drugs — $2,100 in 2026 and $2,400 in 2027. Extra Help can bring those costs down even further for people who qualify.

What Extra Help actually does

Extra Help is a federal program run by Social Security and Medicare. If you qualify, it can lower or eliminate your Part D plan premium, reduce your deductible, and cap what you pay per prescription at the pharmacy.

As of 2024, Congress expanded the program so that everyone who qualifies now gets the "full" benefit — there is no longer a partial tier. That change makes the program simpler and more generous for people just above the old income line.

Who qualifies

Eligibility is based on two things: your income and your resources (savings and certain assets).

• Income: Generally, your income must be at or below 150% of the federal poverty level. That limit is adjusted each year and is higher if you support other family members in your household.
• Resources: Things like money in checking, savings, stocks, and bonds are counted. Your home, one car, personal belongings, and burial plots do not count.

You may automatically qualify — with no application needed — if you have Medicare and also receive Medicaid, Supplemental Security Income (SSI), or help from a Medicare Savings Program.

If you're not sure, apply anyway. Social Security will do the math for you, and there's no cost to apply.

How to apply

You can apply for Extra Help in three ways:

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

Applications are accepted year-round — you do not have to wait for the Annual Enrollment Period (Oct. 15 – Dec. 7). If you're approved, you also get a Special Enrollment Period to join or switch a Part D plan outside the normal windows.

How Extra Help fits with Part D changes for 2027

Even without Extra Help, Part D continues to look different in 2027:

• The maximum annual deductible is $615 in 2026 and $700 in 2027.
• Once you spend $2,100 in 2026 (or $2,400 in 2027) out of pocket on covered drugs, you pay nothing more for the rest of the year.
• The old "donut hole" coverage gap is gone — Part D now has three simpler phases.
• If monthly costs are still hard to manage, the Medicare Prescription Payment Plan lets you spread your drug costs across the year in level monthly payments, at no extra charge.

Extra Help works on top of all of this. For someone who qualifies, the annual cap — $2,100 in 2026 and $2,400 in 2027 — becomes more of a ceiling than a target, and most enrollees will pay far less.

Local help in Schererville

Schererville is in Lake County, where residents have access to Medicare plan choices from multiple carriers during each enrollment period. But for personal questions — like whether you qualify for Extra Help, or which drug plan works best with the medications you take — the most reliable free help comes from Indiana's State Health Insurance Assistance Program (SHIP). SHIP counselors are trained volunteers who do not sell insurance.

You can reach Indiana SHIP at 1-800-452-4800 or online at medicare.in.gov.