Medicare Part D

How the Low-Income Subsidy Lowers Medicare Costs in Salisbury

SALISBURY, Md. — For many people on Medicare, prescription drugs are the biggest monthly worry. A federal program called Extra Help, also known as the Low-Income Subsidy (LIS), can make those costs a lot easier to manage — and more people qualify than realize it.

Salisbury is in Wicomico County, where Medicare drug coverage follows the same national rules that apply across Maryland and the country. Extra Help is one of those national programs, and 2027 brings some important changes to how it works.

What Extra Help actually does

Extra Help is a federal benefit that pays part of your Medicare Part D prescription drug costs. Depending on your income and savings, it can reduce or eliminate your Part D monthly premium, wipe out the plan deductible, and cap what you pay at the pharmacy counter at set low amounts for covered generic and brand-name drugs.

It works with any Medicare drug plan — a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage. You keep choosing your plan; Extra Help just quietly lowers what you owe.

Who qualifies in 2027

As of 2024, Congress expanded Extra Help so that everyone who qualifies now gets the full subsidy — the old "partial" tier is gone. That change carries into 2027.

To qualify, your income and resources must fall under limits set each year by the Social Security Administration. As a general guide, single people with income up to about 150% of the federal poverty level and modest savings usually qualify. The exact numbers change every year, so check the current limits at ssa.gov/benefits/medicare/prescriptionhelp before you assume you make too much.

A few things that often surprise people:

• Your home, one car, and personal belongings don't count as resources.
• If you get Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program, you're automatically enrolled in Extra Help — you don't have to apply.
• You can still qualify if you're working part-time.

How Extra Help fits with 2027 Part D changes

Big Part D rules apply to everyone in 2027, whether or not you have Extra Help:

• The out-of-pocket cap is $2,400 in 2027 for covered drugs. Once you hit it, you pay nothing for covered prescriptions the rest of the year.
• The maximum Part D deductible is $700 in 2027, though many plans set it lower.
• The old "donut hole" is gone — Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets anyone with Part D spread drug costs into monthly bills instead of paying big amounts at the pharmacy. It doesn't lower your total, but it smooths the bumps.

Extra Help stacks on top of all of this. If you qualify, you'll usually hit far lower copays long before the $2,400 cap ever comes into play.

How to apply from Salisbury

You can apply for Extra Help three ways:

1. Online at ssa.gov/benefits/medicare/prescriptionhelp 2. By phone at 1-800-772-1213 (TTY 1-800-325-0778) 3. In person at a Social Security office — the nearest one to Salisbury is on Naylor Mill Road.

The application is short, and there's no fee. If you're denied, you can appeal, and you can reapply any time your income or savings change.

For free, unbiased help with the paperwork — or with picking a Part D or Medicare Advantage plan during the Annual Enrollment Period (Oct. 15 – Dec. 7) — reach out to Maryland's SHIP counselors through the Maryland Access Point (MAP) or your local Area Agency on Aging serving Wicomico County. They don't sell plans and don't work on commission.

A note on income and IRMAA

Extra Help is for people with lower incomes. On the other end of the scale, higher earners pay an IRMAA surcharge on their Part B and Part D premiums when income tops $109,000 for a single filer in 2026. Most Salisbury-area retirees fall somewhere in between — no surcharge, but not automatically eligible for Extra Help either. It's still worth checking; the resource limits are more generous than most people expect.