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Low Income Subsidy (LIS)

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Extra Help — How It Works at the Pharmacy

The Low Income Subsidy (LIS), also called Extra Help, is a federal program run by Social Security that helps lower prescription drug costs for people with Medicare.

LIS works with your Medicare drug plan — it does not replace it.

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How LIS Affects You at the Pharmacy

When LIS is active on your Medicare record, it may lower what you pay when you pick up prescriptions.

LIS may help with:

  • Lower prescription copays

  • Some medications costing $0

  • Reduced or eliminated deductibles

  • Removal of Part D late enrollment penalties (when applicable)

Actual costs depend on your drug plan and the medication.

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How Pharmacies See LIS

Pharmacies see LIS directly through Medicare’s system.

  • LIS applies automatically once approved

  • No separate LIS card is issued

  • The pharmacy processes LIS at the register

If a pharmacy says LIS is not active yet:

  • Approval may still be processing

  • A plan or system update may be required

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Important Pharmacy Notes

LIS only applies to covered drugs on your plan’s formulary.

Copays can vary based on:

  • Generic vs. brand medications

  • Preferred vs. non-preferred drugs

  • Plan-specific rules

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How LIS Connects to D-SNP (Dual Eligible) Plans

Extra Help (LIS) does not by itself qualify someone for a D-SNP.

D-SNP plans require Medicare AND qualifying Medicaid coverage.

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How LIS May Indirectly Connect to D-SNP Eligibility

While LIS alone does not create D-SNP eligibility, it may indicate that someone could qualify for additional assistance.

Some individuals who receive LIS:

  • Meet income guidelines for Medicare Savings Programs (MSP)

  • May receive help paying Medicare premiums and cost-sharing

  • May qualify for partial Medicaid benefits, depending on the MSP level

  • May become eligible for certain D-SNP plan levels, based on state rules 

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Why LIS Matters — Even Without Full Medicaid

  • LIS lowers prescription drug costs

  • LIS may provide Special Enrollment Periods

  • LIS may help when transitioning into:

    • Medicare Savings Programs

    • Medicaid

    • D-SNP plans (when eligible)

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Key Takeaway

  • LIS = Prescription drug cost help

  • Medicaid = Medical coverage

  • D-SNP = Combined Medicare + Medicaid plan

LIS often acts as a first step toward broader assistance, but each program has separate rules.

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Qualifications (Income & Resource Guidelines)

Income and resource limits are set by Social Security and may change.
Eligibility is based on countable income and countable resources, not income alone.​​

Estimated Resource (Savings) Limits

Resources are not just your bank balance.
Some savings count, while many items do not.

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Where to Find the Current LIS (Extra Help) Limits

For official and up-to-date information and how to enroll, visit:

These sources provide the most current limits and application details.​​

 

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What Usually Does NOT Count as a Resource

  • Primary home

  • One vehicle

  • Personal belongings

  • Burial plots

(Rules vary and are verified by Social Security.)

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Important Information & Disclosure​

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Anthony's Healthcare provides Medicare education and guidance only. We are not affiliated with or endorsed by the U.S. government, the federal Medicare program, the U.S. Department of Veterans Affairs (VA), or any state Medicaid agency, or any insurance carrier.

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Medicare consists of multiple parts (Part A, Part B, Part C, and Part D), each with its own rules, costs, and coverage limitations. Medicare Advantage (Part C), Prescription Drug Plans (Part D), Medicare Supplement (Medigap) policies, and Special Needs Plans (D-SNP, C-SNP) are offered by private insurance companies that are approved and regulated by Medicare.

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Coverage, premiums, deductibles, copayments, coinsurance, provider networks, formularies, service areas, and extra benefits may vary by plan, carrier, county, and contract year and are subject to change. Extra benefits such as dental, vision, hearing, fitness programs, transportation, over-the-counter allowances, food or grocery benefits, meals, and in-home services are not guaranteed and may have limitations or eligibility requirements.

We do not offer every plan available in your area. Any information we provide is limited to the plans we do offer. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.

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Low Income Subsidy (Extra Help), Medicaid, Medicare Savings Programs, and Dual Eligible Special Needs Plans (D-SNP) are administered by the appropriate federal or state agency. Eligibility, income limits, resource limits, and program availability vary based on individual circumstances and are determined solely by the applicable agency.

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Information provided is for educational purposes only and does not guarantee eligibility, coverage, or enrollment.

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