Medicare Part D

Extra Help Could Cut Your Medicare Drug Costs in 2026

RIVERTON, Wyo. — For people on Medicare who worry about the price of their prescriptions, there is a federal program that quietly does a lot of heavy lifting. It's called Extra Help, sometimes known as the Low-Income Subsidy, or LIS. And going into 2026, it's worth a fresh look.

Extra Help is run by Social Security and Medicare to lower what people with limited income and resources pay for their Part D drug coverage. If you qualify, it can reduce or eliminate your Part D premium and deductible, and cap what you pay at the pharmacy counter.

What Extra Help actually does

Extra Help works alongside a Medicare Part D drug plan. According to CMS — Medicare Part D program rules (medicare.gov), people who qualify get help with:

• Their monthly Part D premium (up to a set benchmark amount).
• The annual Part D deductible.
• Copays for covered prescriptions at the pharmacy.

Since 2024, Extra Help has been a single, "full" benefit — the older "partial" tier was expanded so that everyone who qualifies now gets the full subsidy. That change matters because it made the program simpler and more generous for people near the income line.

Who qualifies in 2026

To get Extra Help, you generally need to:

• Have Medicare Part A and/or Part B,
• Live in one of the 50 states or D.C., and
• Have income and resources under the program limits.

For 2025, the income limit is set at 150% of the federal poverty level, with resource limits around $17,600 for an individual and $35,130 for a married couple living together (limits are updated each year — check medicare.gov or ssa.gov for the current 2026 figures). Resources include things like money in checking, savings, stocks, and bonds — but not your home, one car, or personal belongings.

Some people qualify automatically, including those who have both Medicare and Medicaid, get Supplemental Security Income (SSI), or are in a Medicare Savings Program. If that's you, you don't need to apply — you'll get a letter.

Everyone else has to apply, and it's free to do so.

How Extra Help fits with the 2026 drug cost changes

2026 brings some big Part D changes for everyone, not just people getting Extra Help:

• A new $2,100 out-of-pocket cap on covered Part D drugs.
• A maximum Part D deductible of $615.
• The old coverage gap ("donut hole") is gone as of 2025, replaced by a simpler three-phase design.
• The Medicare Prescription Payment Plan lets anyone with Part D spread drug costs into monthly payments instead of paying big bills at the pharmacy.

Extra Help sits on top of all this. If you qualify, your out-of-pocket costs are already far below the $2,100 cap, and your copays for covered drugs are limited to small set amounts.

How to apply

There are three easy ways to apply for Extra Help:

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.

You can apply any time of year — there's no enrollment window for Extra Help itself. Once you're approved, you still need to be enrolled in a Part D plan for the subsidy to work. If you're not already in one, Medicare can help match you to a plan.

Local help in Riverton

Riverton is in Fremont County, where Medicare beneficiaries have a range of stand-alone Part D and Medicare Advantage drug plans available during the Annual Enrollment Period (Oct. 15 – Dec. 7) and, for Advantage members, the Medicare Advantage Open Enrollment Period (Jan. 1 – March 31).

For free, unbiased, one-on-one help comparing options with Extra Help in mind, Wyoming's State Health Insurance Assistance Program (SHIP) — called Wyoming SHIIP — offers counseling to Medicare beneficiaries at no cost. Counselors don't sell plans; they explain your choices.