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Do I qualify for Medicare Part D Low-Income Subsidy?

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The Low-Income Subsidy, also known as Extra Help, can help pay Medicare Part D prescription drug costs for those who qualify. Learn more about how you qualify for the Low-Income Subsidy and how to apply for assistance.

How the Low-Income Subsidy helps with prescription drug costs

The Low-Income Subsidy program may help with Medicare Part D costs like premiums, deductibles, copayments, and other prescription drug costs. For example, in 2019, those who get the Low-Income Subsidy won’t pay more than $3.40 for a covered generic prescription drug or $8.50 for a covered brand-named medication.

According to the Social Security Administration (SSA), Extra Help is estimated to be worth about $,4,900 a year. Those who qualify get either “partial” or “full” Extra Help; the amount of financial assistance you may receive will vary depending on your income and asset levels.

Eligibility for the Low-Income Subsidy

Eligibility for the Medicare Low-Income Subsidy is based on your income and asset levels, which may change from year to year.

To be eligible for Extra Help, you must:

  • Be enrolled in Medicare Part A and Part B
  • Live in one of the 50 United States or the District of Columbia
  • Have a yearly income of $18, 735 or less (for individuals) or $25, 365 or less (for married couples living together).
  • Have resources totaling $28,720 or less (for married couples living together) or $14,390 or less (for individuals)

Types of income that affect eligibility for the Low-Income Subsidy

The Social Security Administration looks at certain types of income and resources to decide if you’re eligible for the Low-Income Subsidy.

Resources that are counted include:

  • Checking accounts
  • Savings accounts
  • Stocks and bonds
  • Real estate investments beyond your home

Resources that are not counted:

  • The value of one home
  • The value of one car
  • Burial plot
  • Burial expenses (up to $1,500 if you’ve set aside money for that purpose)
  • Furniture and other household items
  • Personal belongings
  • Life insurance policy
  • Back payments from Social Security or Supplemental Security Income

What if my income and resources exceed limits for the Low-Income Subsidy?

Even if your yearly income and countable resources exceed the listed limits, you may still be eligible for the Low-Income Subsidy in some situations.

For example, the following circumstances are taken into consideration when determining your eligibility for the Medicare Low-Income Subsidy:

  • You have earnings from work.
  • You reside in Alaska or Hawaii.
  • You financially support other family members who live with you.

If your income and resource levels exceed the eligibility limits, but one of the above situations applies to you, it might be worth submitting an application just in case. If you have other questions about eligibility for the Low-Income Subsidy, you can contact Social Security (contact information below).

How to apply for the Low-Income Subsidy

You can apply for the Low-Income Subsidy through your state’s Medicaid program or by contacting the Social Security Administration (SSA). You can reach Social Security by:

  • Calling 1-800-772-1213. TTY users can call 1-800-325-0778. Representatives are available Monday through Friday, from 7AM to 7PM in all U.S. time zones.
  • Visiting an SSA office in person.
  • Applying online through the Social Security website.

Please note that even if you aren’t eligible for the Extra Help program one year, you can always reapply another year if your income levels change.

Do you have more questions on the Low-Income Subsidy? If you’d like help finding Medicare plan options that could help with prescription drug costs, contact us to speak with a licensed eHealth insurance agent. Compare Medicare prescription drug plans at your convenience by typing your zip code in the box on this page.

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