Medicare Part D

Methuen residents on Medicare: could you qualify for Extra Help with drug costs in 2027?

Methuen, Mass. — If prescription costs are stretching your budget, there is a federal program that could quietly do a lot of the heavy lifting. It is called Extra Help, also known as the Low-Income Subsidy, and it helps people with Medicare pay for their Part D drug coverage. For 2027, more people than ever may qualify, and the application is free.

Methuen is in Essex County, where residents choose Part D coverage either as a stand-alone drug plan or built into a Medicare Advantage plan. Extra Help works with either path.

What Extra Help actually does

Extra Help is a federal program that pays part of your Part D drug plan costs. If you qualify, it can reduce or eliminate your monthly Part D premium, wipe out the Part D deductible (the maximum allowed is $615 in 2026 and $700 in 2027), and cap what you pay for each covered prescription at a low set amount.

It works alongside your Part D plan — you keep your plan, and Medicare simply picks up more of the tab. According to Medicare, people who get the full Extra Help benefit pay no more than a few dollars for each covered generic or brand-name drug.

Who qualifies in 2027

Two things determine whether you qualify: your income and your resources (things like money in the bank or investments; your home and car do not count).

Under the current rules, you may qualify for the full Extra Help benefit if:

• Your yearly income is at or below 150% of the federal poverty level, and
• Your resources fall under the program's limits (Social Security publishes the current figures each year).

Some people are automatically enrolled and do not need to apply. That includes people who have both Medicare and full Medicaid (MassHealth in Massachusetts), people who get Supplemental Security Income (SSI), and people in a Medicare Savings Program. If that is you, you should receive a letter from Medicare.

Everyone else has to apply — and many people who qualify never do, simply because they assume they earn too much. It is worth checking.

How the Part D changes fit in

Part D looks different than it did just a couple of years ago. The old "donut hole" coverage gap was eliminated in 2025, and there are now three simpler phases: deductible, initial coverage, and catastrophic coverage. The annual out-of-pocket limit for covered drugs is $2,100 in 2026 and $2,400 in 2027.

On top of that cap, anyone with Part D can also use the Medicare Prescription Payment Plan to spread their yearly drug costs into monthly payments — an option that can help even people who do not qualify for Extra Help.

Extra Help stacks on top of all of this. If you qualify, your share of the cost is even smaller before that annual cap ever comes into play.

How to apply

There are three easy ways to apply, and none of them cost anything:

1. Online at ssa.gov/extrahelp — this is usually the fastest. 2. By phone at 1-800-772-1213 (TTY 1-800-325-0778). 3. In person at your local Social Security office, or with help from Massachusetts SHINE, the state's SHIP (State Health Insurance Assistance Program), which offers free one-on-one Medicare counseling.

Have basic financial information handy: bank statements, investment records, and any income sources. You do not need to be enrolled in a Part D plan first — you can apply for Extra Help any time of year.

What to do after you are approved

If Social Security approves your application, you can join a Part D plan or switch plans outside the usual Annual Enrollment Period (Oct. 15 – Dec. 7). People with Extra Help get a Special Enrollment Period, which means more flexibility if your medications or preferred pharmacy change.

If you are turned down, you can appeal — and it is worth trying again if your income or resources change later.