Medicare Part D

Low-Income Subsidy lowers Medicare Part D bills in Scarborough

SCARBOROUGH, Maine — If you're on Medicare and prescription costs feel tight, there's a federal program you should know about. It's called Extra Help — also known as the Low-Income Subsidy, or LIS — and it can lower what you pay for Part D drug coverage. The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, and Extra Help can bring costs down even further for people who qualify.

Here's a plain-English look at how it works, who qualifies, and how to apply.

What Extra Help actually pays for

Extra Help is a federal benefit that reduces the cost of Medicare Part D — the part of Medicare that covers prescription drugs. Depending on your situation, it can lower or eliminate your Part D monthly premium, reduce or wipe out the Part D deductible (the maximum is up to $615 in 2026 and up to $700 in 2027), and cap what you pay at the pharmacy counter for covered generic and brand-name drugs.

As of 2024, Extra Help is a single, full-strength benefit — the older "partial" tier was expanded so that everyone who qualifies gets the same level of help. That's a meaningful change for people who used to fall just above the old cutoff.

Who qualifies in 2027

Eligibility comes down to two things: income and resources.

• Income: Generally, your annual income must be at or below 150% of the federal poverty level. That threshold updates each year, so check the current number on medicare.gov.
• Resources: Things like money in checking and savings accounts, stocks, and bonds. Your home, one car, household items, and burial plots don't count.

Some people are automatically enrolled and don't need to apply. That includes anyone with full Medicaid (called MaineCare here in Maine), anyone receiving Supplemental Security Income, and anyone in a Medicare Savings Program. If that's you, Social Security or Medicare will send a letter.

If you're close to the limits, apply anyway. The Social Security Administration makes the final call, and the rules on what counts as income and resources are more generous than many people expect.

How to apply

You can apply for Extra Help any time of year — you don't have to wait for the Annual Enrollment Period (Oct. 15 – Dec. 7) or the Medicare Advantage Open Enrollment Period (Jan. 1 – March 31). There are three easy ways:

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

The application is short, and you don't need to have your paperwork perfect to start it. If Social Security needs more information, they'll follow up.

How Extra Help fits with Part D changes for 2027

Big things have happened in Part D recently. In 2025, the coverage gap — the old "donut hole" — was eliminated, and Part D moved to a three-phase structure: deductible, initial coverage, and catastrophic. The annual out-of-pocket maximum for covered Part D drugs is $2,100 in 2026 and $2,400 in 2027. Once you hit that, you pay nothing more for covered prescriptions the rest of the year.

There's also the Medicare Prescription Payment Plan, which lets anyone with a Part D plan spread their drug costs into monthly payments instead of paying big amounts at the pharmacy. It doesn't lower the total — Extra Help does that — but it can smooth out cash flow.

Scarborough is in Cumberland County, where residents have a wide range of Part D and Medicare Advantage options during Open Enrollment. Extra Help travels with you: it applies no matter which stand-alone Part D plan or Medicare Advantage plan with drug coverage you choose.

Where to get personal help

Medicare rules are national, but choosing a plan and applying for benefits is personal. A few free, unbiased places to turn:

• Medicare.gov — the official source for program rules, plan comparisons, and the Extra Help application.
• 1-800-MEDICARE (1-800-633-4227) — available 24/7.
• Maine SHIP (Legal Services for Maine Elders) — the State Health Insurance Assistance Program offers free, one-on-one Medicare counseling for people in Scarborough and across Maine. Call 1-877-353-3771.