Medicare Part D

How the Low-Income Subsidy lowers Part D costs in Evanston

EVANSTON, Wyo. — If prescription costs feel heavier every year, there's a Medicare program worth a fresh look. It's called Extra Help, also known as the Low-Income Subsidy, and it can significantly lower what people pay for Part D prescription drug coverage. Recent changes have made it available to more people than before — including some who were turned down in the past.

Here's what to know, and how folks in Evanston can find out if they qualify.

What Extra Help Actually Does

Extra Help is a federal program run through Social Security and Medicare. For people who qualify, it lowers or eliminates the Part D premium, wipes out the deductible, and caps what you pay at the pharmacy counter at a small set amount per prescription.

That matters even more in 2026, because Part D itself is changing. Medicare now caps yearly out-of-pocket drug spending at $2,100, and the Part D deductible can't be higher than $615. Extra Help sits on top of those protections and pushes costs down further for people with limited income and resources.

Who Can Qualify in 2027

Starting in 2024, Congress expanded Extra Help so that everyone who qualifies gets the full benefit — the old "partial" tier is gone. To qualify, generally you must:

• Be enrolled in Medicare Part A and/or Part B,
• Have income at or below 150% of the federal poverty level, and
• Have resources (like savings and investments) below the annual limit set by Social Security.

Your home, one car, burial funds, and personal belongings don't count as resources. Many people assume they earn "too much" and never apply — and that's often not true. It's worth checking.

Why This Matters in Evanston

Evanston is in Uinta County, where Medicare beneficiaries choose from a range of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage. Extra Help works with either path — it follows the person, not the plan.

If you qualify for Extra Help, you also get a Special Enrollment Period, meaning you don't have to wait for the Annual Enrollment Period (Oct. 15 – Dec. 7) to switch to a drug plan that fits your prescriptions better. You can make a change once per quarter during the first three quarters of the year.

How to Apply

You don't need to pay anyone to apply. It's free, and there are three simple ways:

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

Some people are enrolled automatically — for example, those who have both Medicare and full Medicaid, or who get Supplemental Security Income (SSI). If that's you, you should receive a letter from Medicare; no application needed.

A Companion Tool: The Medicare Prescription Payment Plan

Even people who don't qualify for Extra Help have another option: the Medicare Prescription Payment Plan. Instead of paying a big pharmacy bill all at once, you can spread your yearly drug costs into monthly payments across the calendar year. It doesn't lower your total cost — but it can prevent a painful month at the pharmacy. You can opt in through your Part D or Medicare Advantage drug plan.

Watch the Income Rules on the Other End, Too

Extra Help is for lower incomes, but at the higher end of the scale, an IRMAA surcharge is added to Part B and Part D premiums. In 2026, that begins above $109,000 in income for a single filer. It's a separate rule, but a good reminder that Medicare drug costs depend heavily on your specific financial picture.