Medicare Part D

Extra Help & 2027 Part D Costs — Mukilteo, WA

MUKILTEO, Wash. — With Medicare drug prices still weighing on many household budgets, a federal program called Extra Help — also known as the Low-Income Subsidy, or LIS — is quietly doing some of the heaviest lifting for people who qualify. In 2027, it can wipe out Part D premiums and deductibles for eligible enrollees and cap what they pay at the pharmacy counter at just a few dollars per prescription.

The program was expanded in 2024 so that everyone who qualifies now gets the full benefit, not a partial version. That change is still new to a lot of people, and many who qualify have never signed up.

What Extra Help actually pays for

Extra Help is a federal benefit run by the Social Security Administration and Medicare that reduces the cost of Part D prescription drug coverage. For people who qualify, it can cover the Part D monthly premium (up to a benchmark amount), the annual deductible, and most of the cost-sharing for covered drugs.

For context, Medicare’s Part D rules set a maximum deductible of $700 in 2027 and an annual out-of-pocket cap on covered drugs of $2,400 in 2027, up from $2,100 in 2026. Extra Help enrollees generally never reach either of those numbers, because their copays are held to just a few dollars per prescription set by Medicare each year.

Who qualifies in 2027

Two things determine whether you qualify: your income and your resources.

• Income: Generally, your monthly income must be at or below 150% of the federal poverty level. Social Security counts most income, but not everything — for example, some in-home support and housing help are excluded.
• Resources: These include money in checking and savings accounts, stocks, and bonds. They do not include your home, one car, personal belongings, burial plots, or life insurance.

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. Everyone else has to submit an application, and it’s worth doing even if you’re not sure you qualify. The Social Security Administration makes the final call.

How to apply

There are three straightforward ways to apply, and all of them are free:

1. Online at ssa.gov/extrahelp 2. By phone at 1-800-772-1213 (TTY 1-800-325-0778) 3. In person at your local Social Security office

You can also get one-on-one help from Washington’s State Health Insurance Assistance Program (SHIBA), which offers free, unbiased Medicare counseling by phone and through local sponsors. Applying takes most people about 10 to 15 minutes, and you don’t need to be enrolled in a specific drug plan first.

How Extra Help works with a drug plan

Extra Help doesn’t replace Part D — it works alongside it. You still need to be enrolled in either a stand-alone Part D plan or a Medicare Advantage plan that includes drug coverage. Mukilteo is in Snohomish County, where Medicare beneficiaries have a wide range of Part D and Medicare Advantage options to choose from during Annual Enrollment.

If you get Extra Help, Medicare gives you a Special Enrollment Period, meaning you can change your drug plan once per quarter during the first three quarters of the year — not just during the October 15–December 7 window. That flexibility matters if your medications change or a plan drops a drug from its formulary.

Other tools that can lower drug costs

Even if you don’t qualify for Extra Help, a few other pieces of the 2027 Part D landscape may help:

• The Part D out-of-pocket cap applies to everyone with Part D coverage, regardless of income. It is $2,100 in 2026 and $2,400 in 2027.
• The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the calendar year in monthly installments, at no added cost, instead of paying large amounts at the pharmacy counter.
• IRMAA surcharges, which raise premiums for higher-income beneficiaries, only start above $109,000 in income for a single filer in 2026 — so most people are not affected.