Medicare Part D

Extra Help in Drexel Hill: the Medicare drug program many eligible seniors skip

DREXEL HILL, Pa. — If prescription costs are stretching your budget, there is a federal program built for exactly that situation, and many people who qualify never sign up. It is called Extra Help — sometimes called the Low-Income Subsidy, or LIS — and it lowers what you pay for Medicare Part D drug coverage.

Medicare Part DDrexel Hill, PA

Drexel Hill is in Delaware County, where residents with Medicare can apply for Extra Help at any time of year. There is no enrollment window to wait for, and there is no cost to apply. The tricky part is knowing whether you qualify and avoiding a few common missteps that keep people from getting the help they are entitled to.

What Extra Help actually does

Extra Help is a federal benefit run by the Social Security Administration and Medicare. It lowers three things: your monthly Part D premium, your yearly deductible, and the copay you pay at the pharmacy counter.

As of 2025, the old "donut hole" coverage gap is gone. Part D now has three phases, with a maximum deductible of $615 in 2026 and $700 in 2027, and an out-of-pocket cap of $2,100 in 2026 and $2,400 in 2027 on what any enrollee pays for covered drugs in a year. Extra Help brings those numbers down even more for people who qualify — often to a few dollars per prescription.

Who qualifies

Eligibility is based on income and resources (savings, stocks, and similar assets — not your house or car). Social Security updates the limits each year, and the thresholds are higher than many people assume. You can qualify even if you own your home, have a modest retirement account, or receive a pension.

You are automatically enrolled in Extra Help if you have Medicare and any of the following:

• Full Medicaid coverage
• A Medicare Savings Program through your state
• Supplemental Security Income (SSI)

Everyone else has to apply. If you are not sure whether you qualify, apply anyway. Social Security will do the math for you, and there is no penalty for applying if it turns out you are over the limit.

Common mistakes to avoid

Assuming you make too much. The income and resource limits are higher than most people guess, and they change each year. Do not disqualify yourself before Social Security has a chance to run the numbers.

Thinking Extra Help replaces a Part D plan. It does not. You still need to be enrolled in a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage. Extra Help simply reduces what that plan charges you.

Paying someone to apply. The application is free at ssa.gov, on medicare.gov, at your local Social Security office, or through Pennsylvania's SHIP counselors (called APPRISE in this state). If a company asks for a fee, walk away.

Missing the recheck. Social Security may ask you to confirm your income and resources periodically. If you get a letter, respond by the deadline so your benefit does not lapse.

Forgetting IRMAA is separate. Higher-income enrollees pay an IRMAA surcharge on Part D — that starts above $109,000 in income for a single filer in 2026. Extra Help is for the other end of the income scale.

How to apply from Drexel Hill

You have several free options:

• Apply online at ssa.gov/extrahelp.
• Call Social Security at 1-800-772-1213.
• Visit medicare.gov or call 1-800-MEDICARE for guidance.
• Contact APPRISE, Pennsylvania's State Health Insurance Assistance Program (SHIP), for free one-on-one counseling.

Have basic information ready: your Medicare card, recent bank statements, and any records of income (Social Security, pensions, wages). The application takes most people less than 30 minutes.

What happens after you apply

Social Security will send a written decision, usually within a few weeks. If you are approved, you can also use a Special Enrollment Period to switch or join a Part D plan outside the usual Annual Enrollment Period (Oct. 15 – Dec. 7). If you are denied, the letter will explain how to appeal.

If your monthly drug bills are still hard to manage even with Extra Help, ask about the Medicare Prescription Payment Plan. It is a separate, optional program that lets you spread your out-of-pocket drug costs across the year in monthly payments instead of paying all at once at the pharmacy.