Medicare Part D

Extra Help and Medicare Part D costs in Huntsville

HUNTSVILLE, Ala. — If the price of prescriptions is stretching your monthly budget, there's a federal program that could take a real weight off your shoulders. It's called Extra Help, sometimes known as the Low-Income Subsidy (LIS), and it helps people with Medicare pay for their Part D prescription drug coverage.

Here in Huntsville, thousands of Medicare beneficiaries may qualify but never apply — often because they assume they earn "too much" or they simply don't know the program exists. Let's clear that up.

What Extra Help actually does

Extra Help lowers what you pay for Medicare Part D. That includes your monthly drug plan premium, your yearly deductible, and the copays at the pharmacy counter. People who qualify for the full benefit pay only small, capped amounts for covered generic and brand-name drugs.

Starting in 2025, Congress simplified Extra Help so that everyone who qualifies now gets the full subsidy — the old "partial" tier is gone. That's a meaningful change for people who used to fall just above the old income line.

It also stacks on top of other Part D protections. Even people who don't qualify for Extra Help now have a hard annual out-of-pocket cap on covered drugs — $2,100 in 2026 and $2,400 in 2027 — and the coverage gap ("donut hole") has been eliminated. Extra Help just goes further, cutting costs before you ever hit that cap.

Who qualifies in 2027

Eligibility is based on income and resources. The Social Security Administration, which runs Extra Help, looks at two things:

• Income: Generally at or below 150% of the federal poverty level. For 2025 applications, that's roughly $23,475 a year for one person and $31,725 for a married couple living together. The 2026 and 2027 figures update each spring and track close to these numbers.
• Resources: Things like money in checking, savings, stocks, and bonds. In 2025 the limit was about $17,600 for an individual and $35,130 for a couple. Your home, one car, burial plots, and personal belongings do not count.

Some people get Extra Help automatically and don't need to apply:

• People with both Medicare and full Medicaid (called "dual eligibles")
• People enrolled in a Medicare Savings Program through Alabama Medicaid
• People who receive Supplemental Security Income (SSI)

If that's you, you should receive a letter from Medicare confirming your status.

A local snapshot for Huntsville

Huntsville is in Madison County, where Medicare beneficiaries generally have a wide range of stand-alone Part D drug plans and Medicare Advantage plans with drug coverage to choose from. The exact number of plans available in Madison County changes each year, and you can see the current list at Medicare.gov's Plan Finder.

Why does that matter for Extra Help? Because once you qualify, you can use the subsidy with any Part D plan in the county — and you're allowed to use a monthly Special Enrollment Period to switch stand-alone Part D drug plans or to drop a Medicare Advantage plan and go back to Original Medicare with a stand-alone Part D plan, which is a flexibility most people don't have.

How to apply

You have three easy ways to apply, and it's free:

1. Online at ssa.gov/extrahelp 2. By phone at 1-800-772-1213 (Social Security) 3. In person at the Social Security office in Huntsville

The application is short — most people finish it in under 15 minutes. You don't need to send tax returns or bank statements; you just answer questions about your household income and resources. Social Security may follow up if they need to verify anything.

If you'd like free, unbiased help walking through it, contact the Alabama SHIP (State Health Insurance Assistance Program) at 1-800-243-5463. SHIP counselors are trained volunteers, not salespeople.

What happens after you're approved

Once Social Security notifies you that you qualify, your savings kick in the following month. If you're already in a Part D plan, your new lower costs apply automatically. If you're not enrolled in a drug plan yet, you'll get a Special Enrollment Period to pick one — you don't have to wait for the fall Annual Enrollment Period (October 15 – December 7).

It's also worth knowing about the Medicare Prescription Payment Plan, a separate 2025 feature that lets anyone with Part D spread their drug costs into monthly installments. It doesn't lower your total cost, but it can smooth out an expensive month. You can use it whether or not you have Extra Help.