The Medicare Extra Help program, also known as the Low-Income Subsidy (LIS), offers significant financial assistance to Medicare enrollees with limited income and resources. Eligible individuals benefit from reduced costs for prescription drugs, as well as lower premiums, deductibles, and copays.
For 2025, the income limits for Extra Help have been increased to reflect cost-of-living adjustments. This change allows more individuals to qualify for the program and access its valuable support.
Eligibility for the Extra Help Program
The Extra Help program is available to individuals who meet the following criteria:
- Reside in one of the 50 U.S. states or Washington, D.C.
- Are enrolled in both Medicare Part A and Part B
- Are a member of a qualified Medicare Part D plan, either standalone or through a Medicare Advantage Prescription Drug (MAPD) plan
- Have income and assets at or below the annual limits set by the Department of Health and Human Services (HHS)
Additionally, individuals enrolled in Medicaid automatically qualify for the Extra Help program.
The Medicare Extra Help Program
The Extra Help, also known as the Low-Income Subsidy (LIS) program, offers financial assistance to Medicare beneficiaries, helping them manage the cost of prescription drugs. The level of support provided depends on the beneficiary’s income.
The program offers two tiers of assistance:
- Full Extra Help: Provides the most comprehensive support, covering plan premiums, deductibles, and copays, significantly reducing prescription drug costs.
- Partial Extra Help: Available to beneficiaries whose income slightly exceeds the eligibility threshold. This level offers reduced assistance, helping with premiums and copays.
Both options aim to make prescription medications more affordable for those who qualify.
How to Apply for Extra Help in 2025
If you believe you may qualify for the Extra Help program in 2025, follow these steps to apply. Keep in mind that individuals enrolled in Medicaid are automatically enrolled in the Extra Help program.
- Apply Online: Visit the Social Security Administration (SSA) website to submit your application.
- Apply by Phone: Call the SSA at 800-772-1213 or TTY 800-325-0778. Representatives are available Monday through Friday, from 8:00 AM to 7:00 PM Central Time.
- Apply In Person: Schedule an appointment at your local Social Security office by calling the SSA. Use the Social Security Office Locator to find the nearest office.
Assistance is available to guide you through the application process and ensure your enrollment.
Extra Help Income and Asset Limits for 2025
To qualify for the Low-Income Subsidy (LIS)/Extra Help program in 2025, beneficiaries must meet the income and asset thresholds established by the Social Security Administration.
- Income Limits:
- Individuals: $22,590
- Married couples: $30,660
- Asset Limits:
- Individuals: $16,100
- Married couples: $32,130
Assets include resources such as bank accounts, stocks, and bonds. Beneficiaries must meet both the income and asset requirements to be eligible for this financial assistance program.
Resources Considered for Extra Help Eligibility
When applying for Extra Help, the following resources are evaluated:
- Real estate other than your primary residence
- Bank accounts, including checking, savings, and certificates of deposit (CDs)
- Stocks, U.S. Savings Bonds, and mutual funds
- Individual Retirement Accounts (IRAs)
- Cash assets
Resources Excluded from Consideration for Extra Help
The following items are not counted as resources when determining eligibility for Extra Help:
- The beneficiary’s primary residence
- Personal vehicles
- Items that cannot be easily converted into cash, such as jewelry or furniture
- Rental properties used for personal financial support or land used to grow food for personal consumption
- Life insurance policies or burial expense policies, including interest earned on funds set aside for burial expenses
Medicare agents can assist beneficiaries with applications for the Medicare Savings Program (MSP) and the Low-Income Subsidy (LIS). Additionally, some applicants may qualify for Dual-Eligible Special Needs Plans (DSNPs). Agents should verify the applicant’s level of Extra Help and guide them in exploring DSNP options available in their area.
Not affiliated with or endorsed by Medicare or any government agency.
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