Medicare Part D
Auburn readers ask: do I qualify for Extra Help with Medicare drug costs?
AUBURN, Maine — If prescription costs are stretching your budget, there is a federal program you may not have heard called by its real name. It is called the Low-Income Subsidy, and most people know it as Extra Help. It is designed to lower what people with Medicare pay for their Part D prescription drugs, and thousands of Mainers who could qualify never apply.
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Key takeaways
- Extra Help is a federal program that lowers Part D premiums, deductibles and copays for people with limited income and resources.
- Part D's annual out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, and the maximum deductible is $615 in 2026 and $700 in 2027 — Extra Help reduces those costs further for those who qualify.
- You can apply for Extra Help any time of year through the Social Security Administration, not just during Medicare's fall enrollment window.
- Auburn residents can get free, unbiased help applying through Maine's SHIP program (called Maine SMP/SHIP) or by calling 1‑800‑MEDICARE.
This guide walks through who is eligible, what Extra Help actually does, and the small mistakes that keep people from getting it.
What Extra Help actually pays for
Extra Help is a benefit tied to Medicare Part D, the part of Medicare that covers prescription drugs. If you qualify, the program can lower or eliminate your Part D monthly premium, reduce your deductible, and cap what you pay at the pharmacy counter for covered drugs.
According to CMS — Medicare Part D program rules (medicare.gov), people who receive Extra Help pay significantly less for generic and brand-name prescriptions than the standard Part D cost-sharing amounts. This sits on top of the broader Part D structure: the yearly out-of-pocket cap on covered drugs is $2,100 in 2026 and $2,400 in 2027, and the maximum deductible is $615 in 2026 and $700 in 2027.
The old "donut hole" coverage gap was eliminated in 2025, so Part D now has three simpler phases: deductible, initial coverage, and catastrophic. Extra Help softens the cost in each of those phases.
Who qualifies in 2027
Eligibility is based on two things: your income and your resources (savings and certain assets). The exact limits are set each year by the Social Security Administration and adjusted for inflation.
You automatically qualify for Extra Help if you have Medicare and also have:
- Full Medicaid coverage,
- Help from a Medicare Savings Program paying your Part B premium, or
- Supplemental Security Income (SSI) benefits.
If none of those apply, you can still qualify by applying directly. As of 2024, Congress expanded Extra Help so that everyone who meets the income test now receives the full benefit — there is no longer a "partial" level. Check medicare.gov or ssa.gov for the current-year income and resource limits before you apply.
The mistakes that keep people from getting it
A few common misunderstandings stop Auburn-area residents from applying:
"My income is a little too high, so I won't bother." Many people underestimate what counts and what doesn't. Certain income and household expenses are excluded from the calculation. It is worth applying and letting Social Security do the math.
"I own my home, so I have too much in assets." Your home does not count. Neither does one vehicle, personal belongings, or a burial plot. The resource test looks mainly at things like checking, savings and investment accounts.
"I missed the fall enrollment window." Extra Help has no annual enrollment period. You can apply any month of the year. If approved, you also get a special enrollment period to pick or change a Part D plan.
"I already have a Part D plan, so this doesn't apply to me." Extra Help works with your existing Part D or Medicare Advantage drug coverage. You do not need to drop your plan to receive it.
How Auburn residents can apply
Auburn is in Androscoggin County, and residents have several no-cost ways to apply:
- Online at ssa.gov/extrahelp
- By phone at Social Security, 1‑800‑772‑1213
- In person at a local Social Security office
- With help from Maine's State Health Insurance Assistance Program (SHIP), which offers free one-on-one Medicare counseling
If you are approved and want to review whether your current drug plan still fits, you can also use the Medicare Prescription Payment Plan — a separate option that lets any Part D enrollee spread out-of-pocket drug costs across monthly payments instead of paying a large bill at the pharmacy.
Key dates to remember
Extra Help itself has no deadline. But if you use your approval to switch Part D plans, keep these Medicare windows in mind:
- Annual Enrollment Period: October 15 – December 7, for changes that take effect January 1.
- Medicare Advantage Open Enrollment: January 1 – March 31, for one change if you are already in a Medicare Advantage plan.
People with Extra Help also get additional chances during the year to change drug coverage if needed.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Androscoggin County
(MA penetration in Androscoggin County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Try it
Find your 2026 Medicare premium
Most people pay the standard Part B premium. If your 2024 income was higher, an income-related surcharge (IRMAA) applies. Enter your details to see your bracket.
Surcharges are added to your premiums and based on your 2024 tax return. Married-filing-separately uses a different schedule. Confirm at Medicare.gov.
Try it
How the 2026 Part D drug cap works
Slide to your estimated yearly prescription costs and see how the new $2,100 out-of-pocket cap protects you. This illustrates the standard Part D benefit; your plan may structure costs differently.
Once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for the rest of 2026. Confirm details at Medicare.gov.
Good to know
Frequently asked questions
Does Extra Help cost anything to apply for?
Will Extra Help affect my other benefits, like SSI or Medicaid?
What if I was denied Extra Help in the past?
How is Extra Help different from a Medicare Savings Program?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Also for Auburn
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This page was last updated: October 6, 2026.