Medicare Part D

Extra Help & Medicare Drug Costs in Howell, NJ

HOWELL, N.J. — If prescription costs feel tight, there's a federal program many people in Monmouth County may qualify for but never claim: Extra Help, also called the Low-Income Subsidy (LIS). It's designed to make Medicare Part D drug coverage more affordable, and the rules changed recently to let more people in.

Here's a plain-language look at how Extra Help works, who qualifies for 2027, and how to apply.

What Extra Help actually does

Extra Help is a federal benefit run through Medicare and the Social Security Administration. If you qualify, it lowers what you pay for your Medicare Part D prescription drug plan — including your monthly premium, your deductible, and the cost of covered drugs at the pharmacy.

Since 2024, the program has been "full" Extra Help only. That means there's no more partial tier — people who qualify get the full subsidy, which is a meaningful change from earlier years.

Extra Help works alongside your Part D plan or a Medicare Advantage plan that includes drug coverage. It doesn't replace them; it reduces what you personally owe.

Who qualifies for 2027

Eligibility is based on two things: your income and your resources (savings and certain assets).

For 2025 applications, the general limits set by Social Security are:

• Income: Up to 150% of the federal poverty level. For 2025 applications that worked out to roughly $23,475 a year for a single person and about $31,725 for a married couple living together. Social Security updates the limits each year, and they typically rise slightly.
• Resources: Around $17,600 for an individual and $35,130 for a married couple. This includes money in checking, savings, stocks, and bonds. It does not count your home, one car, personal belongings, burial plots, or life insurance.

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

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

If any of those apply, Medicare mails you a notice. Keep it.

Why it matters more in 2027

Part D has been reshaped over the last two years, and 2027 brings more changes worth knowing:

• The out-of-pocket cap for covered Part D drugs is $2,100 in 2026 and $2,400 in 2027. Once you hit it, you pay nothing more for the rest of the year on covered drugs.
• The maximum Part D deductible is $615 for 2026 and $700 for 2027.
• The old "donut hole" coverage gap is gone as of 2025 — Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets anyone with Part D spread their yearly drug costs into monthly payments, at no extra charge.

Extra Help stacks on top of all of this. If you qualify, your share of drug costs stays well below the annual cap, and your premium and deductible may be reduced to zero for a benchmark plan.

How to apply from Howell

Howell is in Monmouth County, where residents have access to a broad range of stand-alone Part D and Medicare Advantage drug plans during Medicare's enrollment windows. Extra Help itself, though, is a separate application — and you can apply any time of year.

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

You do not need a lawyer or a paid service. The application is free.

If you're denied or unsure, New Jersey's State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling. In Monmouth County, SHIP counselors can walk through your paperwork with you.

What happens after you qualify

Once Social Security approves you, Medicare will either keep you in your current drug plan (if it qualifies) or enroll you in a benchmark plan in your area. You'll get a letter explaining your new copay level for generic and brand-name drugs.

You can also switch drug plans once per quarter during the first three quarters of the year if you have Extra Help — a special enrollment right most people don't have. That's on top of the regular Annual Enrollment Period (Oct. 15 – Dec. 7) and Medicare Advantage Open Enrollment (Jan. 1 – March 31).

A quick word on income surcharges

Extra Help is for people with limited income. On the other end, higher-income beneficiaries pay an IRMAA surcharge on Part B and Part D. For 2026, IRMAA starts above $109,000 in income for a single filer. It's the mirror image of Extra Help — same program, different end of the income scale.