Medicare Part D

Extra Help Could Ease Medicare Drug Costs in Derby

DERBY, Kan. — Prescription drug costs are one of the biggest worries people bring to Medicare. The good news: there's a federal program called Extra Help, also known as the Low-Income Subsidy (LIS), that can lower what many people pay for their Part D prescription drugs. If you or someone you love is stretching a fixed income in Derby, it's worth a careful look.

What Extra Help Actually Does

Extra Help is run by Social Security and Medicare to reduce Part D costs for people with limited income and resources. According to CMS — Medicare Part D program rules (medicare.gov), people who qualify get help with:

• Their Part D monthly premium (up to a set benchmark amount).
• Their Part D deductible.
• Their copays at the pharmacy for covered drugs.

In 2026, the standard Part D maximum deductible is $615 and the new out-of-pocket cap is $2,100. Extra Help lowers those numbers substantially for people who qualify, and in many cases the deductible is eliminated altogether.

Who Qualifies in 2026

As of 2024, Congress expanded Extra Help so that everyone who qualifies now gets the full benefit — the old "partial" tier is gone. To qualify, you generally need to:

• Be enrolled in (or eligible for) Medicare Part A and/or Part B.
• Have an income at or below 150% of the federal poverty level.
• Have limited resources (savings, investments, real estate other than your home) under the current federal limit.

Some people are enrolled automatically. If you have Medicaid, get help from a Medicare Savings Program, or receive Supplemental Security Income (SSI), you're placed into Extra Help without applying.

The Mistakes People Make Most Often

This is where a lot of Derby-area readers get tripped up. A few common ones to avoid:

• Assuming you won't qualify. Income limits are higher than many people expect, and the resource test does not count your home, one vehicle, or personal belongings.
• Not reapplying after a life change. A divorce, a spouse's death, or a drop in income can push you into eligibility even if you didn't qualify before.
• Skipping Part D entirely to save money. Going without creditable drug coverage can trigger a late enrollment penalty that follows you for life.
• Confusing Extra Help with a Medicare Savings Program. They're separate — one helps with drug costs, the other helps with Part B premiums and cost-sharing. Many people qualify for both.

How Extra Help Works With Your Plan

Extra Help doesn't replace a Part D plan — it works alongside one. You still need to be enrolled in a stand-alone Part D drug plan or a Medicare Advantage plan that includes drug coverage. Derby is in Sedgwick County, where multiple Part D and Medicare Advantage plans are offered; Extra Help can be applied to a plan you already have or one you choose during enrollment.

If your monthly drug bills swing wildly month to month, ask about the Medicare Prescription Payment Plan, a separate 2025 option that lets you spread your out-of-pocket drug costs evenly across the year. It doesn't lower the total — but it smooths the cash flow.

How and When to Apply

You can apply for Extra Help any time of year — there's no window to wait for. Three ways to do it:

1. Online at ssa.gov/extrahelp. 2. By calling Social Security at 1-800-772-1213. 3. In person at your local Social Security office.

If you're approved mid-year, you also get a Special Enrollment Period to join or switch a Part D plan outside the regular Annual Enrollment Period (Oct. 15 – Dec. 7).

A Quick Word on Higher Incomes

Extra Help is for lower incomes, but it's worth knowing the other end of the scale too. In 2026, IRMAA surcharges — extra Part B and Part D premiums for higher earners — begin above $109,000 in income for a single filer. Most Derby residents on fixed retirement income won't hit that, but planners often flag it for people with a one-time income spike (like selling a house).