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. 

*Eligibility for Extra Help and the Low-Income Subsidy (LIS) is determined based on income and resource limits set by the federal government. Not all individuals will qualify. Please consult with a licensed Medicare advisor to determine your eligibility 

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.

• ** A 2.5 percent COLA would increase the average benefit for a retired worker — about $1,920 a month in August 2024 — by $48 a month starting in January 2025. The average monthly survivor benefit ($1,509 in August) would go up by a little less than $38, and the average Social Security Disability Insurance (SSDI) payment ($1,540 in August) would tick up by $38.50.  reference: AARP.

Income and Asset Limits: These limits help determine your eligibility for the program, and in some cases, certain types of income may not count against you.

Financial Flexibility: The Extra Help program offers some leeway in calculating income, making it easier for you to qualify for assistance.

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.

Your Action Plan

• Read 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: 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.