How to Get Help Paying for Medicare: Extra Help, LIS, and Medicare Savings Programs Explained

Medicare is not free. Even with Original Medicare, beneficiaries face a standard Part B premium of $185 per month in 2026, a Part B deductible of $257, a Part A deductible of $1,676 per benefit period, and 20% coinsurance for most outpatient services with no out-of-pocket maximum.

For someone living on a fixed income, these costs can be significant. Fortunately, the federal government and states administer several programs specifically designed to reduce or eliminate Medicare costs for people with limited income and resources. Millions of eligible beneficiaries are not enrolled in these programs, often because they are unaware they qualify or do not know how to apply.

This guide covers every major assistance program, explains who qualifies, and walks through the application process step by step.

Extra Help, officially known as the Low Income Subsidy (LIS), is a federal program administered by the Social Security Administration that helps pay Medicare Part D prescription drug costs. In 2026, the program can save eligible beneficiaries up to $5,900 per year.

What Extra Help covers: Depending on your income and resource level, Extra Help can pay some or all of your Part D premium, reduce or eliminate your Part D deductible, and significantly lower your copays for covered drugs. Full Extra Help beneficiaries pay no more than $4.50 for generic drugs and $11.20 for brand-name drugs in 2026.

Who qualifies: To qualify for Extra Help in 2026, your income must be at or below 150% of the Federal Poverty Level. For an individual, that is approximately $23,340 per year. For a married couple, it is approximately $31,860 per year. Your countable resources must be at or below $17,220 for an individual or $34,360 for a couple.

What counts as a resource: Countable resources include bank accounts, stocks, bonds, and mutual funds. Your primary home, one vehicle, personal belongings, life insurance policies, and burial funds up to $1,500 per person are excluded from the calculation.

Automatic enrollment: If you receive full Medicaid benefits, Supplemental Security Income (SSI), or a Medicare Savings Program, you are automatically enrolled in Extra Help. You do not need to apply separately.

Medicare Savings Programs (MSPs) are state-administered programs that help pay Medicare premiums, deductibles, and copays for people with limited income and resources. There are four types, each with different eligibility thresholds and benefits.

Note: Income limits are approximate and states may apply slightly different thresholds. Florida follows the federal guidelines with minor variations. Contact your state Medicaid office for the most current figures.

The QMB program is the most comprehensive. If you qualify, providers who accept Medicare are prohibited by law from billing you for Medicare cost-sharing. This means no copays, no deductibles, and no coinsurance for covered services under Original Medicare. If a provider attempts to bill you for cost-sharing and you are enrolled in QMB, you have the right to report them to your State Medical Assistance office.

The SLMB and QI programs pay only the Part B premium, which is $185 per month in 2026. This alone saves eligible beneficiaries $2,220 per year.

Applying for Extra Help is straightforward and can be done in three ways:

Online: Visit ssa.gov and complete the Application for Extra Help with Medicare Prescription Drug Plan Costs (Form SSA-1020). The online application takes approximately 15 minutes.

By phone: Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778). Representatives are available Monday through Friday, 8 a.m. to 7 p.m.

In person: Visit your local Social Security office. You can find the nearest office at ssa.gov/locator.

Social Security will notify you by mail within approximately 30 days whether you qualify. If approved, your Extra Help will be applied to your Part D plan automatically. You do not need to contact your drug plan separately.

If you are denied, you have the right to appeal the decision. You must request an appeal within 60 days of receiving the denial notice.

In Florida, Medicare Savings Programs are administered by the Agency for Health Care Administration (AHCA) through the Medicaid program. You can apply in the following ways:

Online: Visit the ACCESS Florida portal at myflorida.com/accessflorida. You can create an account and submit an application for Medicaid and Medicare Savings Programs in one step.

By phone: Call the Florida Medicaid helpline at 1-866-762-2237.

In person: Visit your local Department of Children and Families (DCF) service center.

Through a SHINE counselor: Florida's SHINE (Serving Health Insurance Needs of Elders) program provides free Medicare counseling through trained volunteers. SHINE counselors can help you complete the application and answer questions about your eligibility. To find a SHINE counselor near you, call the Elder Helpline at 1-800-963-5337.

Once approved, your Medicare Savings Program benefit is typically applied retroactively to the first day of the month in which you applied. If you have been paying a Part B premium that should have been covered, you may receive a refund.

Beyond Extra Help and Medicare Savings Programs, several other programs can reduce Medicare-related costs for eligible beneficiaries.

Medicaid: If you qualify for full Medicaid benefits, Medicaid acts as secondary insurance and covers most Medicare cost-sharing, including deductibles and copays. You are also automatically enrolled in Extra Help. Learn more about the relationship between the two programs in our article on having both Medicare and Medicaid.

State Pharmaceutical Assistance Programs (SPAPs): Some states offer additional drug cost assistance beyond Extra Help. Florida does not currently have a state-funded SPAP, but residents may qualify for manufacturer patient assistance programs for specific medications.

Medicare Advantage Special Needs Plans (SNPs): Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for people who have both Medicare and Medicaid. These plans often include additional benefits such as dental, vision, hearing, and transportation. Learn more about Medicare Special Needs Plans.

Veterans Benefits: If you are a veteran, the Department of Veterans Affairs (VA) may cover prescription drugs and other health services at low or no cost. VA benefits and Medicare can work together, and having both can significantly reduce your out-of-pocket costs.

Pharmaceutical manufacturer programs: Many drug manufacturers offer patient assistance programs for people who cannot afford their medications. NeedyMeds (needymeds.org) and RxAssist (rxassist.org) maintain searchable databases of available programs.

If you are already enrolled in a Part D prescription drug plan and you are approved for Extra Help, your benefit will be applied to your current plan. You will also gain a Special Enrollment Period that allows you to switch to a different Part D plan once per quarter during the first three quarters of the year.

This is important because not all Part D plans are equally cost-effective for Extra Help beneficiaries. Some plans have premiums above the Extra Help benchmark amount, which means you would still owe a partial premium. A licensed Medicare specialist can identify plans in your area where Extra Help covers the full premium, leaving you with no monthly drug plan cost.

If you are enrolled in a Medicare Advantage plan that includes drug coverage (MAPD), Extra Help applies to the drug portion of your plan in the same way.