Medicare Part D

How the Low-Income Subsidy Lowers Part D in Radford

RADFORD, Va. — If prescription costs are stretching your budget, there's a federal program that could quietly take a big weight off your shoulders. It's called Extra Help, sometimes known as the Low-Income Subsidy (LIS), and it's designed to lower what people with Medicare pay for their Part D prescription drugs.

Here's what Radford readers should know about who qualifies, how it fits with the 2027 Part D changes, and how to apply.

What Extra Help actually does

Extra Help is a Medicare program run by the Social Security Administration that reduces the cost of Part D prescription drug coverage. If you qualify, it can help pay your Part D premium, deductible, and copays at the pharmacy.

As of 2024, Congress expanded Extra Help so that everyone who qualifies now gets the full subsidy — the old "partial" tier is gone. That means more people pay very little at the pharmacy counter for covered drugs.

Extra Help works alongside the broader 2027 Part D rules set by CMS, including:

• A Part D out-of-pocket cap of $2,100 in 2026 and $2,400 in 2027 on covered drugs.
• A Part D deductible that can't exceed $615.
• The elimination of the old "donut hole" coverage gap (Part D now has just three phases).
• The optional Medicare Prescription Payment Plan, which lets anyone with Part D spread drug costs across the year in monthly installments.

Extra Help is separate from those changes, but stacked together they can make a real difference.

Who qualifies in 2026–2027

Extra Help has two tests: an income test and a resource (asset) test. The exact figures adjust each year, but as a general guide from Social Security:

• Income: Generally up to about 150% of the federal poverty level. For 2025, that's roughly $23,475 a year for a single person and $31,725 for a married couple living together. Higher limits may apply in Alaska and Hawaii, and certain income (like some help from family) may not count.
• Resources: Generally up to about $17,600 for an individual and $35,130 for a couple in 2025. Resources include things like money in checking, savings, stocks, and bonds. Your home, one car, burial plots, personal belongings, and life insurance usually don't count.

You may automatically qualify — with no application needed — if you already have:

• Full Medicaid,
• A Medicare Savings Program (like QMB, SLMB, or QI), or
• Supplemental Security Income (SSI).

If that's you, Medicare will send a letter, usually on purple, yellow, or green paper, telling you that you're enrolled.

Why it's worth checking, even if you're not sure

Many people who qualify never apply because they assume their income is "too high" or they don't want to bother with paperwork. Social Security estimates that millions of eligible people are still missing out.

A few things worth knowing:

• You can apply any time of year — there's no deadline like the fall enrollment window.
• Applying is free. No one should charge you to fill out this form.
• Even if you were denied in the past, it's worth trying again after the 2024 expansion — the rules are more generous now.

How to apply from Radford

Radford is in Radford City, an independent city in Virginia, and residents there have several free ways to get help:

1. Apply online at ssa.gov/extrahelp. 2. Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to apply by phone or request a paper application. 3. Visit your local Social Security office. The office serving Radford is in Christiansburg. 4. Call 1-800-MEDICARE (1-800-633-4227) for general Medicare questions. 5. Contact Virginia's SHIP, called the Virginia Insurance Counseling and Assistance Program (VICAP), at 1-800-552-3402. SHIP counselors give free, unbiased, one-on-one help — including with Extra Help applications and comparing Part D options.

When you apply, it helps to have your Social Security number, bank statements, investment records, tax return, and information about any pensions or other income handy.

What happens after you're approved

If Social Security approves you, they'll notify Medicare. You'll then be enrolled in a Part D plan if you don't already have one, and your drug costs at the pharmacy should drop right away.

A few tips:

• Review your Part D plan every year. Even with Extra Help, plans change their drug lists (formularies) and pharmacy networks. The Annual Enrollment Period runs October 15 – December 7 each year.
• Keep your approval letter. Show it at the pharmacy if you're ever charged more than expected.
• Report changes in income, marriage, or household size to Social Security — they can affect your subsidy.

Extra Help is separate from the Medicare Advantage Open Enrollment Period (January 1 – March 31), which lets people already in a Medicare Advantage plan make one switch.