Medicare Part D

Extra Help With Medicare Drug Costs in Pittsburg: Who Qualifies

PITTSBURG, Kan. — If you take regular prescriptions and Medicare feels tight on your budget, 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 (LIS). It helps people with limited income and resources pay for their Medicare Part D drug coverage.

A Pittsburg guide to Extra Help with prescription costs

Extra Help isn't a plan you shop for. It's a benefit you qualify for, and then it works alongside a Part D drug plan or a Medicare Advantage plan that includes drug coverage. Here's how it works for folks in and around Pittsburg.

What Extra Help actually does

According to the Social Security Administration and Medicare.gov, Extra Help can lower or eliminate your Part D premium and deductible, and it caps what you pay at the pharmacy counter for covered drugs. Since 2024, the program has been "fully" expanded — meaning there's no longer a partial benefit tier. If you qualify, you get the full subsidy.

That matters even more heading into 2027, when Medicare's regular Part D rules include:

• A $2,400 annual out-of-pocket cap on covered prescription drugs in 2027 (up from $2,100 in 2026)
• A maximum Part D deductible of $700 in 2027 (up from $615 in 2026)
• No more coverage gap ("donut hole") — Part D now has three simpler phases
• The option to spread drug costs across the year through the Medicare Prescription Payment Plan

For someone with Extra Help, out-of-pocket costs are generally far below that annual cap.

Who qualifies in 2027

Two things are looked at: your income and your resources (things like money in checking, savings, stocks, and bonds — not your home or your car).

General guidelines from the Social Security Administration:

• Income: Generally up to about 150% of the federal poverty level. For 2025 applications, that was roughly $23,475 a year for a single person and $31,725 for a married couple living together. Figures used for 2026 and 2027 applications are updated by SSA.
• Resources: Roughly $17,600 for an individual and $35,130 for a married couple (2025 limits; check SSA for the latest 2026 and 2027 figures).

You may qualify automatically — without applying — if you already have:

• Full Medicaid coverage
• Help from your state paying your Medicare Part B premium (a Medicare Savings Program), or
• Supplemental Security Income (SSI)

If that's you, Medicare mails a notice letting you know.

How to apply from Pittsburg

Applying is free, and no one should ever charge you to help you file. You can apply in any of these ways:

1. Online at ssa.gov/extrahelp 2. By phone with Social Security at 1-800-772-1213 (TTY 1-800-325-0778) 3. In person at a Social Security office. The office serving Pittsburg is located in Pittsburg, Kansas, and also serves surrounding Crawford County communities. 4. With free local help from Kansas SHICK (Senior Health Insurance Counseling for Kansas), the state's SHIP program. SHICK counselors don't sell anything — they help you understand your options. Call 1-800-860-5260.

You can apply anytime — you do not have to wait for Medicare's Annual Enrollment Period (Oct. 15 – Dec. 7).

What happens after you're approved

Once you qualify for Extra Help, you'll still need a Part D drug plan (or a Medicare Advantage plan that includes drug coverage) to actually use the benefit. Pittsburg is in Crawford County, where Medicare beneficiaries have a range of stand-alone Part D plans and Medicare Advantage plans with drug coverage to choose from. Extra Help gives you additional flexibility: you can change plans more often than most people — generally once per quarter during the first three quarters of the year — so you can move if your plan stops covering a drug you need.

To compare plans available in Crawford County, use the Plan Finder at Medicare.gov/plan-compare, or ask a SHICK counselor to walk through it with you.

Common mistakes worth avoiding

• Assuming you won't qualify. Many people who could get Extra Help never apply. If you're close to the income and resource limits, apply anyway — Social Security makes the final call.
• Confusing Extra Help with Medicaid. They're separate programs, though people on full Medicaid automatically get Extra Help.
• Skipping Part D entirely. If you don't sign up for drug coverage when you're first eligible and don't have other creditable coverage, you can owe a late enrollment penalty for as long as you have Part D.
• Paying someone to apply. The application is always free.