Medicare Supplement

Extra Help in Waterbury: Who Qualifies for Drug Cost Aid in 2026

WATERBURY, Conn. — Prescription costs can catch anyone off guard, especially on a fixed income. If you have Medicare and your budget feels tight, there's a federal program worth knowing about: Extra Help, also called the Low-Income Subsidy (LIS). It helps pay for Medicare Part D prescription drug coverage — including premiums, deductibles, and what you pay at the pharmacy counter.

Waterbury seniors: a federal program could ease your drug bills

Waterbury is in New Haven County, where Medicare Part D plans are offered county-wide. Extra Help itself, though, is a national program run by the Social Security Administration and the Centers for Medicare & Medicaid Services (CMS). The rules are the same whether you live on Bank Street or out toward Bunker Hill.

What Extra Help actually does

Extra Help lowers the cost of Part D drug coverage for people with limited income and resources. Under current Medicare Part D program rules, people who qualify pay much less for their covered prescriptions and generally have no Part D premium or deductible for a benchmark plan.

Here's some helpful context for 2026:

• The standard Part D out-of-pocket cap is $2,100 for the year.
• The maximum Part D deductible is $615.
• The old "donut hole" coverage gap is gone — as of 2025, Part D has three simpler phases.
• Anyone on Part D can also use the Medicare Prescription Payment Plan, which spreads your drug costs into monthly payments across the year instead of one big pharmacy bill.

Extra Help sits on top of those rules and reduces what qualifying enrollees owe.

Who qualifies in 2026

Eligibility is based on two things: your income and your resources (things like money in checking, savings, stocks, and bonds — your home and car don't count).

As of 2024, the program was expanded so there's now one level of full Extra Help rather than the older "partial" tier. In general, you may qualify if:

• Your income is at or below 150% of the federal poverty level, and
• Your resources fall under the annual limit set by Social Security.

You automatically get Extra Help if you have Medicare and also:

• Have full Medicaid coverage (in Connecticut, that's HUSKY Health/Title 19), or
• Get help from a Medicare Savings Program, or
• Receive Supplemental Security Income (SSI).

If none of those apply but money is tight, don't assume you're out. Many people who qualify never apply. Check the current income and resource limits at ssa.gov/extrahelp before ruling yourself out.

How to apply from Waterbury

There's no fee to apply, and you can do it any time of year:

1. Online at ssa.gov/extrahelp. 2. By phone at 1-800-772-1213 (Social Security). 3. In person at a Social Security office — the Waterbury field office serves this area. 4. Free local help from Connecticut's SHIP program, called CHOICES, at 1-800-994-9422. Counselors are trained to walk you through the paperwork.

If you're approved, Social Security will send a letter explaining your effective date and what to do next about picking or keeping a Part D plan.

What changes once you have Extra Help

A few things to know so you don't miss out:

• You still need a Part D plan. Extra Help pays toward a plan; it isn't a plan itself.
• You get extra chances to switch plans. People with Extra Help have a Special Enrollment Period that lets them change Part D plans once per quarter during the first three quarters of the year, outside of normal enrollment windows.
• Regular Medicare deadlines still matter for everyone else: Annual Enrollment runs Oct. 15 – Dec. 7, and Medicare Advantage Open Enrollment runs Jan. 1 – March 31.
• Higher earners pay more, not less. IRMAA surcharges on Part B and Part D start above $109,000 in income for a single filer in 2026 — that's the opposite end of the income scale from Extra Help.

A quick note on plan choices in New Haven County

Waterbury residents shopping for Part D or Medicare Advantage will see plans available across New Haven County. The exact number of plans and carriers changes each year, and CMS publishes Star Ratings (1 to 5 stars) that reflect quality and member experience. Ratings are useful information, but the right plan really depends on your drugs, your pharmacy, and your doctors. The Plan Finder at medicare.gov/plan-compare lets you enter your medications and see how each plan would treat them.