Medicare Part D

Low-Income Subsidy: Medicare drug help in Greenwood

GREENWOOD, S.C. — If prescription costs are stretching your budget, there's a federal program that can quietly take a lot of that weight off your shoulders. It's called the Low-Income Subsidy, and most people know it by its friendlier name: Extra Help.

Extra Help is run by Medicare and the Social Security Administration. It lowers what people with limited income and savings pay for their Part D prescription drugs. And starting in 2024, the program expanded — meaning more people qualify than ever before, but many still don't know they're eligible.

Here's what Greenwood-area readers should understand before the next trip to the pharmacy.

What Extra Help actually does

Extra Help works alongside your Medicare Part D drug plan. If you qualify, it can:

• Lower or eliminate your Part D monthly premium (up to a set benchmark amount).
• Reduce or eliminate your Part D deductible.
• Cap what you pay at the pharmacy counter to small, fixed copays for covered generic and brand-name drugs.
• Remove the late enrollment penalty if you didn't sign up for Part D when you were first eligible.

The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, and the maximum plan deductible is $615 in 2026 and $700 in 2027. Extra Help sits on top of those protections and pushes costs down further for people who qualify.

Who qualifies in 2027

Eligibility is based on two things: income and resources (savings and certain assets, not your home or car).

As a general guide from Medicare:

• Your income needs to be at or below 150% of the federal poverty level.
• Your resources need to fall under the annual limit set by Social Security (this figure is updated each year — check ssa.gov for the current number).

A few important notes:

• If you already have Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program, you automatically get Extra Help. You don't need to apply.
• Since 2024, the program pays the full Extra Help benefit to everyone who qualifies. The old "partial" tier was eliminated.
• Not all income counts. Things like housing assistance and some in-kind support are excluded.

If you're close to the limits, apply anyway. Many people are surprised to learn they qualify.

How to apply

You can apply for Extra Help in three ways, and it's free:

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.

The application is short — usually about 10 minutes. You'll need basic information about your income, savings, and any investments. Social Security will send a decision letter, and if you qualify, they'll pass your information to Medicare so it can be applied to your drug plan.

How Extra Help fits with a Part D plan in Greenwood

Greenwood is in Greenwood County, where Medicare beneficiaries can choose from a range of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage. Extra Help works with either option — it follows you to whichever Part D plan you enroll in.

If you qualify for Extra Help mid-year, you also get a Special Enrollment Period, which means you don't have to wait until the Annual Enrollment Period (October 15 – December 7) to change plans. You can switch drug plans once per quarter during the first three quarters of the year.

Other tools worth knowing about

Extra Help isn't the only way Medicare is trying to make drug costs more predictable:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, limiting what any Part D enrollee will spend on covered drugs in a year.
• The Medicare Prescription Payment Plan lets you spread your yearly drug costs into smaller monthly payments instead of paying a big bill at the pharmacy. It's optional and free to sign up for through your drug plan.
• Medicare Savings Programs (run by South Carolina Medicaid) can help pay Part B premiums and, in some cases, other Medicare costs. Qualifying for one of these also gets you automatic Extra Help.