Medicare Part D

Clifton Medicare Part D and the Extra Help program

CLIFTON, N.J. — For many older adults in Clifton, the monthly trip to the pharmacy can feel heavier than it should. There's a federal program that may make it lighter, and it doesn't get talked about enough: the Low-Income Subsidy, better known as Extra Help.

A quieter way to lower prescription costs in Clifton

Extra Help is a Medicare program that assists people with limited income and savings in paying for their Part D prescription drug coverage. It can reduce or even eliminate the Part D premium and deductible for people who qualify, and it caps what they pay at the pharmacy counter for covered drugs. According to the Centers for Medicare & Medicaid Services (CMS), the program was expanded in 2024 so that everyone who qualifies now gets the full benefit — there is no longer a "partial" Extra Help tier.

Who qualifies for Extra Help

Extra Help is based on income and resources, not on health status. The Social Security Administration reviews:

• Income — generally up to 150% of the federal poverty level.
• Resources — things like money in checking, savings, stocks, and bonds. Your home, one car, burial plots, and household belongings do not count.

The exact income and resource limits are updated each year and are posted on ssa.gov and medicare.gov. Married couples living together are counted jointly. If you're close to the line, it's worth applying anyway — many people who assume they earn too much actually qualify.

Some people get Extra Help automatically and don't have to apply. That includes people who have both Medicare and full Medicaid (NJ FamilyCare), those enrolled in a Medicare Savings Program, and people who get Supplemental Security Income (SSI).

Why this matters more in 2027

Part D is changing in ways that help every enrollee, but Extra Help stacks on top of those changes.

• The Part D out-of-pocket cap is $2,100 in 2026. Once you hit that amount in covered drug costs, you pay $0 for the rest of the year for covered drugs.
• The Part D maximum deductible is $615 in 2026.
• The old "donut hole" coverage gap was eliminated in 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets anyone with Part D spread their drug costs into monthly payments across the year — helpful if a big bill hits in January.

For someone with Extra Help, those numbers can drop much further. That's why applying is worth the 20 minutes it takes.

Clifton is in Passaic County — here's what that means for plans

Medicare plan availability is set at the county level. Clifton is in Passaic County, so the drug plans and Medicare Advantage plans with drug coverage available to Clifton residents are the same ones offered across the county. If you qualify for Extra Help, you can use it with any Part D plan or Medicare Advantage plan that includes drug coverage in Passaic County.

You can compare what's offered by using the Plan Finder at medicare.gov/plan-compare and entering your ZIP code (07011, 07012, 07013, or 07014, depending on your neighborhood).

How to apply from Clifton

There are three easy ways to apply for Extra Help:

1. Online at ssa.gov/extrahelp — the fastest option. 2. By phone at 1-800-772-1213 (Social Security). 3. In person at a Social Security office. The office serving Clifton residents is typically the Paterson SSA office; call first to confirm hours or set an appointment.

You can apply at any time of year — you don't have to wait for the Annual Enrollment Period (Oct. 15 – Dec. 7). And if you qualify for Extra Help, you also get a Special Enrollment Period to join or switch a Part D plan outside the usual windows.

For free, one-on-one help from someone who does not sell insurance, contact New Jersey SHIP (State Health Insurance Assistance Program) at 1-800-792-8820. Passaic County also has an Office on Aging that can point you to local counselors.