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Understanding Extra Help and Low-Income Subsidy (LIS) for 2025
As you navigate the world of Medicare, you may find that the costs associated with your healthcare can add up quickly. That’s where the Extra Help program, also known as the Low-Income Subsidy (LIS), comes in. This program is designed to make Medicare more affordable for those with limited income, helping you manage out-of-pocket expenses so you can access the care you need without the financial stress.
How Extra Help Can Benefit You
- Lower Your Medicare Costs: Extra Help is here to assist with your out-of-pocket expenses, including premiums, deductibles, and coinsurance.
- Focused Assistance: This program is especially helpful in reducing the costs of your Medicare Part D prescription drug coverage.
How to Apply
Getting started with Extra Help is simple and straightforward. The Social Security Administration (SSA) handles the application process, and you’ll need to provide some documentation to show your income and assets. This ensures that the program supports those who truly need it.
- Easy Application: You can apply through the Social Security Administration’s Extra Help page or by calling 1-800-772-1213.
- Income Verification: You’ll need to provide proof of income, but don’t worry, the process is designed to be as smooth as possible.
Am I Eligible?
To qualify for Extra Help in 2025, your income and assets will need to fall within certain limits.
In 2024, the monthly income limit was:
$1,719 for individuals
$2,309 for couples.
There are also specific asset limits, but the SSA does provide a small buffer by disregarding $20 of your unearned income.
- Income and Asset Limits: These determine whether you qualify, and some income may not count against you.
- Financial Flexibility: The program offers some leeway in calculating your income, making it easier to qualify.
What Will Extra Help Do for Me?
Extra Help can significantly reduce what you pay for your Medicare Part D prescription drugs. It can also cover your Part D premiums up to a state-specific benchmark, which can save you money each month. Plus, the program provides a Special Enrollment Period (SEP) that allows you to make changes to your Medicare Part D plan outside of the usual enrollment periods if needed.
- Lower Drug Costs: You’ll pay less for your prescriptions.
- Premium Coverage: The program can take care of your Part D premiums, up to a certain amount.
- Flexible Enrollment: If your needs change, you can switch plans during a Special Enrollment Period.
Additional Information
When you apply for Extra Help, you might also be screened for other Medicare Savings Programs, which could offer even more financial assistance. It’s important to note that while Extra Help significantly reduces costs, it doesn’t replace your Medicare Part D plan. Instead, it works alongside it to ensure you can manage your healthcare expenses effectively.
- Potential Dual Benefits: The application may also qualify you for Medicare Savings Programs.
- Works with Part D: Extra Help complements, rather than replaces, Medicare Part D coverage.
Important 2025 Update: Expanded Eligibility for Full LIS
Starting January 1, 2024, more people will qualify for the Full LIS program. If your income is up to 150% of the federal poverty level (FPL), you’ll now be eligible for Full LIS, which means no Part D premium or deductible and minimal copayments. This change could make a big difference in what you pay out-of-pocket.
- More People Qualify: The Full LIS program is now available to more individuals, offering even greater savings.
Your Action Plan
Watch for Your Annual Notice of Change (ANOC): Each September, you’ll receive a notice that details any changes to your Medicare plan, including updates to your Extra Help benefits. It’s important to review this carefully to stay informed.
Review Your Coverage: Make sure your current plan still meets your needs, especially with the expanded LIS eligibility. If something changes, you’ll want to know as soon as possible.
Consider Making Changes During Open Enrollment: If you decide you need to adjust your coverage, remember that you can do so during the Medicare Open Enrollment period from October 15 to December
By staying informed and reviewing your options each year, you can make sure you’re getting the most out of the Extra Help program and keeping your healthcare costs as low as possible.
Get Personalized Assistance
If you have any questions or need help with your options, don’t hesitate to reach out. We’re here to help you understand your Medicare benefits and find the coverage that’s right for you.
Apply for Extra Help Now: Visit the Social Security Administration’s Extra Help page or call 1-800-772-1213 to get started.
Give Us a Call: We can assist you in finding the right Medicare Advantage plan and see what plans are available in your area that you may qualify for. Reach out today, and let’s explore the best options for your healthcare needs together.
