The Medicare Low-Income Subsidy Can Save Enrollees Thousands of Dollars

March 23, 2026

The Medicare Low-Income Subsidy (LIS), also known as “Extra Help,” helps low-income Medicare enrollees with Part D prescription drug costs. LIS can easily save individuals with costly prescriptions thousands of dollars per year, with access to $0 premium plans, no deductibles, and lower fixed co-payments.

Despite these major benefits, many people who qualify for LIS have not enrolled. Advocates and counselors can help by talking to their clients about Extra Help and encouraging them to apply.

Seven Facts Advocates Should Know about Medicare LIS

1. People With Medicare Can Enroll in LIS at Any Time in the Year.

Applications can be completed online at the Social Security website or in person at any Social Security office. People newly eligible for LIS have a special enrollment period to enroll in or change their Part D or Medicare Advantage Prescription Drug (MA-PD) plan.

2. LIS Financial Eligibility Is Often More Generous Than Medicaid Eligibility.

It is worth checking if a person qualifies even if they’re not eligible for Medicaid. The LIS application process is also typically less onerous than most Medicaid applications.

3. LIS Eligibility Is Automatic for Individuals on Supplemental Security Income, Medicare Savings Programs, and Other Medicaid Programs.

The Social Security Administration should automatically enroll these individuals in LIS. If a person loses eligibility in Supplemental Security Income, Medicare Savings Programs, or other Medicaid programs, they can still apply separately to LIS. See Justice in Aging’s fact sheet, Medicare Part D Low-Income Subsidy, Medicaid, and the End of the Public Health Emergency: Tips for Advocates, for people losing LIS as a result of losing eligibility for Medicaid.

4. LIS Coverage Lasts Until the End of the Year, Even for Those Who No Longer Qualify for Medicaid.

This can be particularly helpful for older adults with a Medicaid spend-down. If they meet their Medicaid spend-down (also known as share of cost) even once, they qualify for LIS for the rest of the year. If they meet it in July or later, they qualify for LIS for the rest of that year and all of the next year.

5. People With LIS Can Change Standalone Part D Plans Once Each Month.

This can be helpful for clients who have recently been diagnosed with a chronic condition or who have changed prescriptions and find that the formulary of their current plan does not meet their needs. People on LIS also have access to a special enrollment period to drop an MA-PD plan, join Original Medicare, and enroll a standalone plan.^[1]

Example: Rebecca is enrolled in an MA-PD plan and LIS. Her doctor prescribed her a new medication essential to her health but not covered under her MA-PD plan. Rebecca can submit an exceptions request to have her medication covered by her MA-PD plan.^[2] Alternatively, Rebecca can use the special enrollment period to disenroll from Medicare Advantage, join Original Medicare, and choose a standalone prescription drug plan that covers her medication.

6. People With LIS Qualify for a $10 a Month Social Security Overpayment Plan.

It is not uncommon for clients to owe Social Security for an overpayment of benefits. When this happens, clients often find that a large portion of their Social Security benefit is being deducted to pay back the debt. If your client has LIS, however, the client can request that Social Security take out only $10 a month.^[3] Social Security is required to automatically honor the request when it is made.^[4]

7. LIS Is Not Subject to Estate Recovery.

Many older adults are concerned that applying for Medicaid may allow states to recoup costs from their estates. LIS is not a Medicaid program and Federal law does not permit states or the federal government to collect money from estates for LIS costs. Medicare Savings Programs (QMB, SLMB and QI), which are Medicaid programs, are also exempt from estate recovery.^[5]