Medicare Part D

Extra Help & 2027 Medicare Drug Costs, Grove City OH

GROVE CITY, Ohio — If prescription costs have been squeezing your budget, there's a federal program you may be overlooking. It's called Extra Help, also known as the Low-Income Subsidy (LIS), and it's designed to make Medicare Part D drug coverage more affordable for people with limited income and resources.

For 2027, understanding Extra Help matters more than ever. The Medicare Part D out-of-pocket cap on covered drugs is $2,400, and the maximum Part D deductible is $700. Extra Help can lower those costs further — sometimes dramatically — for people who qualify.

Here's what Grove City residents need to know.

What Extra Help Actually Does

Extra Help is a federal benefit that assists with the costs of a Medicare Part D prescription drug plan. Depending on your situation, it can reduce or eliminate your Part D premium, lower your deductible, and cap what you pay at the pharmacy counter for covered generic and brand-name drugs.

As of 2024, Congress expanded the program so that everyone who qualifies now receives the full subsidy — there's no longer a "partial" tier. That change carries forward into 2027, which means more people get meaningful help than in years past.

Extra Help is administered by the Social Security Administration, working alongside the Centers for Medicare & Medicaid Services (CMS).

Who Qualifies in 2027

To qualify for Extra Help, you must be enrolled in Medicare and meet income and resource limits set each year by the federal government. In general terms:

• Income: Your annual income must fall below roughly 150% of the federal poverty level. Some types of income aren't counted, so don't rule yourself out based on a rough estimate.
• Resources: Things like money in checking, savings, stocks, and bonds are counted — but your home, one car, burial plots, and household items are not.

If you already have Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program, you're automatically enrolled in Extra Help — you don't need to apply separately.

For the current year's exact income and resource thresholds, check medicare.gov/extra-help or call Social Security at 1-800-772-1213.

How It Works With Your Drug Plan

Extra Help doesn't replace a Part D plan — it works alongside one. You still choose and enroll in a Medicare prescription drug plan, and Extra Help reduces what you pay.

Grove City is in Franklin County, where Medicare beneficiaries can choose from a range of stand-alone Part D plans and Medicare Advantage plans that include drug coverage. If you qualify for Extra Help and don't pick a plan yourself, Medicare may enroll you in one automatically so your coverage doesn't lapse. You can switch plans if the assigned one isn't a good fit for your medications.

Other Ways to Manage Drug Costs in 2027

Even if you don't qualify for Extra Help, there are new tools worth knowing about:

• The $2,400 out-of-pocket cap. Once your out-of-pocket spending on covered Part D drugs hits $2,400 in 2027, you pay nothing for covered drugs the rest of the year.
• The Medicare Prescription Payment Plan. This optional program lets you spread your Part D out-of-pocket costs into monthly payments across the year instead of paying large amounts at the pharmacy. It doesn't lower the total — it just smooths the cash flow.
• No more donut hole. The old coverage gap was eliminated in 2025. Part D now has three simpler phases: deductible, initial coverage, and catastrophic (where you pay nothing on covered drugs after hitting the cap).

How to Apply

Applying for Extra Help is free, and you can do it three ways:

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

You can apply any time of year — you don't have to wait for Medicare's Annual Enrollment Period (Oct. 15 – Dec. 7). If you're denied, you can reapply if your circumstances change.

For free, unbiased local help, Ohio residents can also contact the Ohio Senior Health Insurance Information Program (OSHIIP), the state's SHIP. Counselors don't sell plans and can walk you through your options.