Medicare Part D

The federal drug subsidy for Medicare Part D in Rawlins

RAWLINS, Wyo. — If prescription costs are stretching your budget, there's a federal program that could take a real weight off your shoulders. It's called Extra Help, sometimes known as the Low-Income Subsidy (LIS), and it's designed to make Medicare Part D drug coverage much more affordable for people with limited income and savings.

Here's what Rawlins-area readers should know about who qualifies, what it pays for, and how to apply.

What Extra Help actually does

Extra Help is a Medicare program run through the Social Security Administration. If you qualify, it can lower or eliminate your Part D plan premium and deductible, and it caps what you pay at the pharmacy counter for covered generic and brand-name drugs at a small set amount.

It also removes the late enrollment penalty for Part D — a helpful detail if you didn't sign up for drug coverage when you first became eligible.

According to the Centers for Medicare & Medicaid Services (CMS), Extra Help is worth thousands of dollars a year on average to people who qualify. But you have to apply (or be automatically enrolled) to get it.

Who qualifies in 2026–2027

Extra Help now offers full benefits to everyone who qualifies — Congress eliminated the old "partial" tier in 2024. To qualify, your income and resources must fall below limits set each year by Social Security.

In general terms, you may qualify if:

• Your income is at or below 150% of the federal poverty level. For 2025, that's roughly $23,475 a year for one person or $31,725 for a married couple living together. (Wyoming uses the same federal figures as the rest of the lower 48.)
• Your resources — things like money in checking, savings, stocks, and bonds — are below the annual limit (about $17,600 for one person and $35,130 for a couple in 2025). Your home, one car, burial plots, and personal belongings don't count.

You're automatically enrolled in Extra Help — no application needed — if you already have:

• Full Medicaid,
• A Medicare Savings Program (which helps pay your Part B premium), or
• Supplemental Security Income (SSI).

If that's you, Social Security or Medicare will mail you a notice. Keep it.

Why this matters more in 2027

Even without Extra Help, Part D has changed a lot. In 2027:

• Out-of-pocket spending on covered drugs is capped at $2,400 for the year (up from $2,100 in 2026).
• The Part D deductible cannot exceed $700 in 2027 (up from $615 in 2026).
• The old "donut hole" coverage gap is gone — Part D now has just three phases.
• You can also spread your drug costs across the year using the Medicare Prescription Payment Plan, an optional monthly smoothing program.

Extra Help sits on top of these changes. If you qualify, your costs are already far below that $2,400 cap, and the deductible generally doesn't apply at all.

How Rawlins fits in

Rawlins is in Carbon County, where Medicare drug coverage is offered through stand-alone Part D plans and through Medicare Advantage plans that include drug coverage. Plan availability is set at the county level, so any Carbon County resident chooses from the same menu of plans, whether you live in Rawlins, Sinclair, or out toward Saratoga.

Extra Help works with any Medicare Part D plan you pick. It doesn't lock you into one carrier, and you can change plans more often than most people can — qualifying for Extra Help gives you a Special Enrollment Period to switch drug plans once per quarter during the first three quarters of the year.

How to apply

There are three easy ways:

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 a Social Security office. The closest offices to Rawlins are in Rock Springs and Casper; call first to check hours.

The application is free and takes most people less than 30 minutes. You don't need to bring pay stubs or bank statements to apply — Social Security will follow up if it needs proof.

You can also get free, unbiased help from Wyoming's State Health Insurance Information Program (Wyoming SHIIP) at 1-800-856-4398. SHIIP counselors don't sell anything and can walk you through the paperwork.