Medicare Part D
Low-Income Subsidy rules for Medicare drugs in Arlington
ARLINGTON, Texas — Prescription costs are one of the biggest worries for people on Medicare. The good news: a federal program called Extra Help — also known as the Low-Income Subsidy, or LIS — can bring those costs way down for people who qualify. And in recent years, the rules have changed to let more people in.
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Click to call 855-729-3240Key takeaways
- Extra Help is a federal program that lowers what you pay for Medicare Part D prescription drug coverage, and since 2024 everyone who qualifies gets the full benefit instead of a partial one.
- People with Extra Help pay no Part D deductible, even though the maximum deductible for others is $700 in 2027, and Extra Help works alongside the annual out-of-pocket cap on Part D spending, which is $2,100 in 2026 and $2,400 in 2027.
- You can apply for free anytime through Social Security online, by phone, or in person, and if you already have Medicaid, SSI, or a Medicare Savings Program you automatically qualify without applying.
- People with Extra Help also get a Special Enrollment Period to change their Part D plan once per quarter during the first three quarters of the year, instead of waiting for the fall enrollment period.
Here's a plain-language look at who qualifies in 2027, what Extra Help covers, and how folks in Arlington can apply.
What Extra Help actually does
Extra Help is a federal benefit that lowers what you pay for your Medicare Part D prescription drug coverage. According to CMS, people who qualify get help with:
- Their Part D monthly premium (up to a benchmark amount)
- Their Part D deductible
- Their copays at the pharmacy for covered drugs
People with Extra Help also get a Special Enrollment Period, which means they can change their Part D drug plan once per quarter during the first three quarters of the year — they don't have to wait for the fall Annual Enrollment Period.
Extra Help is separate from your drug plan itself. You still need to be enrolled in a Medicare Part D plan (or a Medicare Advantage plan that includes drug coverage) to use it.
Who qualifies in 2027
As of 2024, Congress expanded Extra Help so that everyone who qualifies gets the full benefit — the old "partial" tier is gone. To qualify in 2027, you generally need to meet two tests:
- Income: Up to 150% of the federal poverty level. For a single person, that's roughly $23,000 a year; for a married couple living together, roughly around $31,000. (The exact numbers update each year — check medicare.gov for the current figure.)
- Resources: Limited savings and other assets. This includes money in checking, savings, stocks, and bonds — but not your home, one car, personal belongings, or burial plots.
If you already have Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program, you automatically qualify for Extra Help. You don't have to apply.
Why this matters in Arlington
Arlington is in Tarrant County, where Medicare beneficiaries have a wide range of stand-alone Part D drug plans and Medicare Advantage plans with drug coverage to choose from. That's a lot of paperwork to compare — and Extra Help changes the math for many households.
Even better, Extra Help works alongside the Part D annual out-of-pocket cap, which is $2,100 in 2026 and rises to $2,400 in 2027. The cap protects everyone with Part D coverage, but for people with Extra Help, most will hit far lower out-of-pocket totals long before reaching it.
The Part D maximum deductible is $615 in 2026 and $700 in 2027, but people with Extra Help pay no Part D deductible at all.
How to apply
There are three easy ways to apply for Extra Help — and there's no cost to apply:
1. Online at ssa.gov/extrahelp 2. By phone at Social Security: 1-800-772-1213 (TTY 1-800-325-0778) 3. In person at your local Social Security office
You can apply anytime — there's no enrollment window. If you're denied, you can reapply if your income or resources change.
Once you're approved, Social Security notifies Medicare, and your drug plan will apply the lower costs at the pharmacy counter.
Free local help in Arlington
Applications can feel intimidating, especially if you're not sure how to count your resources. Arlington residents can get free, unbiased help from Texas's State Health Insurance Assistance Program (SHIP), called the Health Information, Counseling and Advocacy Program (HICAP) in Texas. HICAP counselors don't sell anything — they help you understand your options.
You can reach Texas HICAP by calling 1-800-252-9240, or find a local counselor through the Area Agency on Aging of Tarrant County.
Don't forget the payment plan option
Even if you don't qualify for Extra Help, you may benefit from the new Medicare Prescription Payment Plan, which lets you spread your Part D drug costs across the calendar year in monthly installments instead of paying big bills at the pharmacy. It doesn't lower your total cost — it just smooths it out. You have to opt in through your drug plan.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Tarrant County
(MA penetration in Tarrant County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Try it
Find your 2026 Medicare premium
Most people pay the standard Part B premium. If your 2024 income was higher, an income-related surcharge (IRMAA) applies. Enter your details to see your bracket.
Surcharges are added to your premiums and based on your 2024 tax return. Married-filing-separately uses a different schedule. Confirm at Medicare.gov.
Try it
How the 2026 Part D drug cap works
Slide to your estimated yearly prescription costs and see how the new $2,100 out-of-pocket cap protects you. This illustrates the standard Part D benefit; your plan may structure costs differently.
Once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for the rest of 2026. Confirm details at Medicare.gov.
Good to know
Frequently asked questions
Q: I was denied Extra Help years ago. Should I try again?
Q: Does Extra Help pay my Medicare Part B premium?
Q: If I get Extra Help, can I still pick my own drug plan?
- CMS — Medicare Part D program rules (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.