Medicare Part D

Medicare Part D and the Low-Income Subsidy in Westfield

WESTFIELD, Ind. — If prescription costs are stretching your budget, there's a federal program that could quietly take a big weight off your shoulders. It's called Extra Help, sometimes known as the Low-Income Subsidy (LIS), and it helps people with Medicare pay for their Part D prescription drug coverage.

Many Hoosiers who qualify never apply — often because they assume they earn too much, or they simply haven't heard of it. Here's a plain-English look at who qualifies, what it covers, and how to apply from right here in Westfield.

What Extra Help actually does

Extra Help lowers what you pay for Medicare prescription drug coverage. According to the Centers for Medicare & Medicaid Services (CMS), people who qualify pay:

• No Part D premium (up to the benchmark amount in their area)
• No Part D deductible
• Much lower copays at the pharmacy for covered drugs

That's meaningful in 2026, when the standard Part D deductible can be as high as $615 and the new out-of-pocket cap on covered drugs sits at $2,100. Extra Help sits on top of those protections — meaning most enrollees will pay only a small copay per prescription.

The coverage gap (the old "donut hole") was fully eliminated in 2025, so Part D now has three simpler phases: deductible, initial coverage, and catastrophic.

Who qualifies in 2027

Extra Help is based on income and resources, not age or health. As of 2024, Congress expanded the program so there is now just one level of full Extra Help — the old "partial" level went away. That means more people qualify for the full benefit than in past years.

In general terms, you may qualify if:

• Your income is at or below 150% of the federal poverty level, and
• Your resources (savings, investments — not your home or car) fall under the program's limits

The exact dollar thresholds are updated each year and posted on Medicare.gov and by the Social Security Administration (SSA). Certain things — like the house you live in, one vehicle, burial funds, and household items — do not count as resources.

You are automatically enrolled in Extra Help if you already have:

• Full Medicaid
• A Medicare Savings Program (MSP), or
• Supplemental Security Income (SSI)

If that's you, you don't need to apply — you'll get a letter from Medicare.

How to apply from Westfield

You can apply for Extra Help any time of year — there's no waiting for open enrollment. There are three easy ways:

1. Online at ssa.gov/extrahelp (this is the fastest option) 2. By phone — call Social Security at 1-800-772-1213 3. In person at a Social Security office. The office serving Westfield is in Noblesville, just a short drive down Ind. 32

Applying is free. No one should ever charge you to fill out this form.

If you're approved, Social Security will send you a notice, and Medicare will match you to a Part D plan if you don't already have one. You can switch plans more freely once you have Extra Help — a helpful flexibility that most Medicare beneficiaries don't get.

Where this fits with your other Medicare choices

Westfield is in Hamilton County, where Medicare beneficiaries can choose between Original Medicare with a stand-alone Part D drug plan, or a Medicare Advantage plan that includes drug coverage. Multiple carriers offer coverage in the county, and the specific options can change each year — the 2027 lineup is spelled out in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder.

Extra Help works with either path, as long as your coverage includes Part D. It does not, by itself, pay for doctor visits, hospital stays, or non-drug costs — that's what programs like the Medicare Savings Programs (through Indiana Medicaid) are for. Many people qualify for both.

Also worth knowing: even people who don't qualify for Extra Help can use the Medicare Prescription Payment Plan in 2027 to spread their drug costs into monthly installments instead of paying big amounts at the pharmacy counter.

Common mistakes to avoid

• Assuming you make too much. The income and resource limits are higher than most people think. It's worth applying.
• Waiting for open enrollment. You can apply for Extra Help any month.
• Ignoring the letter from Medicare or Social Security. These letters tell you if your Extra Help status is changing for the coming year.
• Paying someone to apply. The application is always free through SSA.