The Limited Income Subsidy, also known as “Extra Help,” is a federal program that assists Medicare beneficiaries with low income and limited resources to cover their prescription drug expenses. The program helps reduce or eliminate the premiums, deductibles, and co-payments associated with Medicare Part D prescription drug plans.
Understanding the Limited Income Subsidy (LIS)
Reducing Costs Associated with Your Medicare Part D Plan
Paying for prescription drugs is a common stressor we see at the Resource Center. Our SHIP Counselors (see our article on that here) are well versed with these concerns and are happy to help guide you in the right direction. During your appointment with them, you are also screened for eligibility for Medicare Savings Programs (see our article on that here) and Social Security's Limited Income Subsidy (LIS). LIS is a vital program designed to help eligible individuals manage their prescription drug costs. This benefit is part of the Medicare program and aims to reduce the financial burden on those with limited income and resources.
What is the Limited Income Subsidy?
Who Qualifies for LIS?
Eligibility for the Limited Income Subsidy is determined based on income and resource limits set by the Social Security Administration (SSA). Generally, individuals who are eligible for LIS must meet the following criteria:
- Income Limits: Your income must be below a certain threshold, which is adjusted annually. For 2025, this threshold is approximately $23,478/yr for individuals and $31,725/yr for couples. These figures are subject to change, so it's essential to check current limits.
- Resource Limits: Resources, such as bank accounts and investments, must also fall below a specific limit. For 2024, the resource limit is $17,600 for individuals and $35,130 for couples. Certain resources, like your primary home and vehicle, are excluded from this count.
How to Apply for the Limited Income Subsidy
Applying for the Limited Income Subsidy can be done through several methods:
- Online: You can apply directly through the Social Security Administration’s website here.
- Phone: Contact the Social Security Administration at 1-800-772-1213 to request an application or get assistance with the application process.
- In-Person: Visit your local Social Security office for help with the application.
- With the Assistance of a SHIP Counselor: Request an appointment with one of our trained SHIP counselors who specializes in Medicare benefits. They will screen you for the program and help you apply via SSA’s website if you qualify. Call or visit our Resource Center!
What Does LIS Cover?
The Limited Income Subsidy can significantly reduce your out-of-pocket costs for prescription drugs, including:
- Monthly Premiums: Lowering or eliminating the monthly premiums for your Medicare Part D plan.
- Annual Deductibles: Reducing the amount you must pay before your insurance starts to cover drug costs.
- Co-payments: Lowering the cost of medications at the pharmacy.
Maintaining Eligibility
It’s important to keep your information up to date with the Social Security Administration to maintain eligibility for the Limited Income Subsidy. This includes reporting changes in income, resources, or personal circumstances that might affect eligibility.
We know that Medicare and Social Security programs have a lot of information. It’s totally normal to still have questions, and we’d love to help you find the answer!