Medicare beneficiaries with limited income and assets may qualify for Extra Help with the costs of their prescription drugs through the Part D Low Income Subsidy (LIS) program. Administered by the Social Security Administration (SSA) and Centers for Medicare & Medicaid Services (CMS), this program provides crucial assistance to those who need it most.
Who qualifies for LIS/Extra Help?
Some individuals automatically receive Part D Extra Help if they are enrolled in Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program. If you fall into any of these categories, you do not need to apply for Extra Help separately. However, it is still advisable to consult with a benefits counselor to ensure you are enrolled in the most suitable Part D plan for your needs.
If you are not automatically enrolled in the aforementioned benefits programs, you must apply to Social Security to receive Extra Help. Eligibility requirements can be found on the Social Security website.
What are the benefits of LIS/Extra Help?
As of 2025, most individuals who qualify for Extra Help will enjoy the following benefits:
– No premiums for their drug plan
– No deductibles
– Limited out-of-pocket costs for prescription drugs
In addition to financial assistance, Extra Help also provides important protections such as the ability to join or switch Medicare Part D drug plans during Special Enrollment Periods and exemption from Part D late enrollment penalties.
How the LINET program offers temporary Part D coverage
The Limited Income Newly Eligible Transition (LINET) program offers immediate but temporary Part D prescription drug coverage for low-income Medicare enrollees who qualify for Extra Help but do not have prescription drug coverage. This benefit is available for up to two months until the individual enrolls in a Medicare drug plan.
How do I apply for Medicare Part D LIS/Extra Help?
If you believe you or someone you know may be eligible for Extra Help, you can apply through NCOA’s BenefitsCheckUp® website or directly through the Social Security Administration. Additionally, seeking assistance from your local State Health Insurance Assistance Program (SHIP) can provide valuable guidance on navigating Medicare and finding the most suitable plan for your healthcare needs and financial situation.
In conclusion, the Part D Low Income Subsidy (LIS) program offers vital support to Medicare beneficiaries with limited income and assets. By providing financial assistance and important protections, Extra Help ensures that individuals can access the prescription drugs they need without facing overwhelming costs. If you believe you may qualify for Extra Help, don’t hesitate to explore your options and seek assistance from relevant resources to make the most of this valuable program.
