Medicare Part D

How the Low-Income Subsidy works with Medicare in Hartford

HARTFORD, Conn. — If you take prescription drugs and live on a fixed income, there's a federal program that could quietly cover most of what you'd otherwise pay at the pharmacy counter. It's called Extra Help, also known as the Low-Income Subsidy (LIS). And with the Part D out-of-pocket cap moving from $2,100 in 2026 to $2,400 in 2027, understanding whether you qualify matters more than ever.

Yet many people who could get Extra Help don't apply — often because they assume they earn too much, or they never hear about it. Here's a plain-language guide to who qualifies, what it covers, and how to sign up without making a common mistake.

What Extra Help actually does

Extra Help is a federal benefit run by the Social Security Administration and Medicare. It lowers what you pay for a Medicare Part D prescription drug plan. That can include:

• Your monthly Part D plan premium (up to a benchmark amount)
• Your annual Part D deductible (the maximum is $615 in 2026 and $700 in 2027 for people without Extra Help)
• Your copays at the pharmacy for covered drugs

As of 2024, Congress expanded Extra Help so that everyone who qualifies gets the full subsidy — the older "partial" tier is gone. If you qualify, you qualify all the way.

Extra Help works alongside the broader Part D changes in effect for 2027, including the $2,400 annual out-of-pocket cap (up from $2,100 in 2026) and the optional Medicare Prescription Payment Plan, which lets anyone with Part D spread their drug costs across monthly installments instead of paying large amounts at the counter.

Who qualifies in 2027

To get Extra Help, you must have Medicare and meet income and resource limits set each year by the federal government. As a general guide based on current Social Security rules:

• Income: Roughly at or below 150% of the federal poverty level. For many single people that's around $23,000 a year; for a married couple living together, roughly $31,000. Limits are higher in Alaska and Hawaii.
• Resources: Things like money in checking, savings, stocks, and bonds. The limits were roughly $17,600 for an individual and $35,130 for a married couple in 2025, and adjust slightly each year.

Your home, one car, personal belongings, burial plots, and up to a set amount in burial funds do not count as resources. That trips up a lot of people who assume they have "too much."

You are automatically enrolled in Extra Help — you don't need to apply — if you have Medicare and also:

• Have full Medicaid, or
• Get help from your state Medicaid program paying your Medicare Part B premiums (a Medicare Savings Program), or
• Receive Supplemental Security Income (SSI).

Everyone else who might qualify needs to apply.

The mistakes that cost people the most

A few missteps come up again and again:

A few missteps come up again and again: 1. Assuming you don't qualify. Social Security estimates millions of eligible people never apply. If you're close to the limits, apply anyway — the agency does the math. 2. Counting the wrong things as "resources." Your house and your car don't count. Neither do household goods or life insurance policies with face values of $1,500 or less. 3. Skipping the Medicare Savings Program application. Extra Help pays for drugs. A separate state-run program, the Medicare Savings Program (MSP), can pay your Part B premium and, for some, cost-sharing. In Connecticut, MSP is run by the Department of Social Services. Applying for one does not automatically apply you for the other — though qualifying for MSP does auto-enroll you in Extra Help. 4. Waiting for the Annual Enrollment Period. You can apply for Extra Help any time of year. You do not have to wait for Oct. 15–Dec. 7. 5. Not picking a drug plan. Extra Help pays toward a Part D plan — but you still need to be enrolled in one. If you don't choose, Medicare may enroll you in one automatically, and it may not fit your medications well.

How to apply

There are three straightforward ways:

• Online: ssa.gov/extrahelp
• By phone: Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778)
• In person: At your local Social Security office

You'll be asked about your income, resources, and household. The application is free. Never pay anyone to file it for you.

Hartford is in Hartford County, where beneficiaries have a range of stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage to choose from. The 2027 lineup is detailed in each plan's Annual Notice of Change and on Medicare.gov's Plan Finder. Extra Help can be used with either type of coverage, as long as the plan includes Part D.

Where to get local, unbiased help

For one-on-one help — including comparing drug plans once you have Extra Help — Connecticut residents can contact CHOICES, the state's federally designated SHIP (State Health Insurance Assistance Program). SHIP counselors are trained, free, and don't sell insurance. In Connecticut, CHOICES is reached through the state's Area Agencies on Aging or by calling 1-800-994-9422.

You can also call 1-800-MEDICARE (1-800-633-4227) or visit medicare.gov to compare Part D plans using the Plan Finder tool, which factors in your medications and pharmacy.