Medicare Part D

Extra Help and Medicare Part D drug costs in Galveston

GALVESTON, Texas — If prescription costs weigh on your monthly budget, there's a federal program that can quietly do a lot of the heavy lifting. It's called Extra Help, also known as the Low-Income Subsidy (LIS), and it helps people with Medicare pay for their Part D prescription drug coverage.

Here in Galveston, where many retirees live on fixed incomes, understanding this benefit could mean the difference between filling a prescription and skipping it. Here's a plain-language look at who qualifies, what it covers, and how to apply as you weigh 2027 coverage.

What Extra Help actually does

Extra Help is a federal program run by the Social Security Administration and Medicare. If you qualify, it can lower or eliminate:

• Your Part D monthly premium (up to a set benchmark amount)
• Your Part D deductible
• Your copays for covered prescription drugs

The Part D maximum deductible is $615 in 2026 and $700 in 2027, and the annual out-of-pocket cap on covered drugs is $2,100 in 2026 and $2,400 in 2027. Extra Help sits underneath those protections, bringing costs down further for people who qualify. For many enrollees, copays at the pharmacy drop to just a few dollars per prescription.

Who qualifies for 2027

Thanks to changes from the Inflation Reduction Act, full Extra Help benefits are now available to everyone who qualifies — there is no longer a partial LIS tier. To be eligible, you generally need to meet both an income and a resource limit set by Social Security each year.

As a rough guide, you may qualify if:

• Your income is at or below 150% of the federal poverty level, and
• Your resources (savings, investments, and similar assets — not counting your home or car) fall under the annual limit set by Social Security.

You may automatically get Extra Help if you:

• Have both Medicare and full Medicaid
• Get Supplemental Security Income (SSI)
• Are enrolled in a Medicare Savings Program through Texas Medicaid

If any of those apply, you should receive a letter from Medicare — no application needed.

Why this matters heading into 2027

The Part D benefit looks different than it did just two years ago. The old "donut hole" coverage gap was eliminated in 2025, leaving three simpler phases: deductible, initial coverage, and catastrophic. And the out-of-pocket cap — $2,100 in 2026 and $2,400 in 2027 — gives every Part D enrollee a hard ceiling on covered drug spending.

Extra Help stacks on top of those protections. For someone taking several brand-name medications, that can turn an unaffordable year into a manageable one.

There's also the Medicare Prescription Payment Plan, a separate option that lets anyone with Part D spread their drug costs into monthly payments across the year. It doesn't lower the total bill, but it can smooth out the cash-flow shock of a large refill. You can use it alongside Extra Help if you qualify for both.

How to apply from Galveston

Galveston is in Galveston County, and Texas residents apply for Extra Help the same way as everyone else. You have three main options:

1. Online at ssa.gov/extrahelp — the fastest route for most people. 2. By phone at 1-800-772-1213 (Social Security). 3. In person at your local Social Security office. There is a Social Security office serving the Galveston area; call first to confirm hours or schedule an appointment.

You don't need to wait for a special enrollment window to apply — Extra Help applications are accepted year-round. If you're approved, you'll also get a Special Enrollment Period to join or switch a Part D plan outside the usual Annual Enrollment Period (October 15 – December 7).

Free, unbiased help is available from the Texas Health Information, Counseling and Advocacy Program (HICAP) — Texas's State Health Insurance Assistance Program (SHIP). Counselors can walk you through the application and check your Part D options.

What to have ready before you apply

Gathering your paperwork ahead of time makes the application much smoother. Have these handy:

• Your Medicare card
• Recent bank statements
• Statements for investments, stocks, bonds, or retirement accounts
• Your most recent tax return, if you filed one
• Pay stubs, if you or your spouse still work

Social Security won't count your home, your car, personal belongings, or life insurance policies toward the resource limit.