Medicare Part D

Extra Help in 2026: Who Qualifies for Medicare Drug Savings

MEMPHIS — If prescription costs are stretching your budget, there's a federal program that could take real pressure off — and more people qualify than you might think. It's called Extra Help, sometimes known as the Low-Income Subsidy (LIS), and it helps pay for Medicare Part D prescription drug coverage.

Memphis seniors: A closer look at Extra Help for 2027 drug costs

Recent changes have expanded who can get full Extra Help, and the program is working alongside continuing Part D updates for 2027. Here's what Memphis-area readers should know.

What Extra Help actually does

Extra Help lowers what you pay for Medicare Part D. If you qualify, it can reduce or eliminate your monthly Part D premium and deductible, and cap what you pay for covered prescriptions at the pharmacy.

As of 2024, the program was simplified so that everyone who qualifies now gets the full Extra Help benefit — the old "partial" tier is gone. That change carries into 2027 and makes the program more valuable for people who fall just above the old limits.

Who qualifies in 2027

Eligibility is based on your income and resources. According to the Social Security Administration and CMS, you may qualify if:

• Income is generally at or below 150% of the federal poverty level.
• Resources (things like money in checking, savings, stocks, and bonds) fall under the program's limits. Your home, one car, and personal belongings don't count.

Some people qualify automatically and don't need to apply. This includes people who have both Medicare and Medicaid, people in a Medicare Savings Program, and people who receive Supplemental Security Income (SSI). If that's you, you'll get a notice in the mail.

If you're close to the limits, apply anyway. The formulas allow certain deductions, and many people are surprised to learn they're eligible.

How Extra Help fits with 2027 Part D changes

Even if you don't qualify for Extra Help, the Part D program itself continues to look different in 2027:

• The annual out-of-pocket cap on covered Part D drugs is $2,400 in 2027 (up from $2,100 in 2026). Once you hit that ceiling, you pay nothing for covered drugs the rest of the year.
• The maximum Part D deductible is $700 in 2027 (up from $615 in 2026).
• The old "donut hole" coverage gap is gone. Part D now has three simpler phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets anyone with Part D spread their yearly drug costs into monthly payments — no interest, no fees. You have to opt in through your drug plan.
• IRMAA (the higher-income surcharge) kicks in above $109,000 for a single filer in 2026.

For people with Extra Help, costs are even lower than the standard cap, and the paperwork is simpler.

How to apply

There are three easy ways to apply for Extra Help — and applying is 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

You can also get free, unbiased help from Tennessee's State Health Insurance Assistance Program (SHIP), called TN SHIP, at 1-877-801-0044. SHIP counselors don't sell anything.

If you're approved, Social Security will send a letter explaining your benefit. You can apply any time of year — you don't have to wait for Medicare's Annual Enrollment Period.

What's available around Memphis

Memphis is in Shelby County, where a wide range of stand-alone Part D drug plans and Medicare Advantage plans with drug coverage are offered each year. Plan choices are set at the county level, so two people living just across a county line can see different options.

To compare what's available for your ZIP code and your specific medications, use the Plan Finder at medicare.gov or call 1-800-MEDICARE.

Key dates to remember

• October 15 – December 7: Medicare Annual Enrollment Period. You can join, switch, or drop a Part D or Medicare Advantage plan.
• January 1 – March 31: Medicare Advantage Open Enrollment Period. If you're already in a Medicare Advantage plan, you get one chance to switch or return to Original Medicare.
• Extra Help applications: Any time, all year.

If you qualify for Extra Help, you also get a Special Enrollment Period that lets you change Part D plans outside the normal windows — a helpful safety net if your medications change.