Extra Help (Low Income Subsidy) for Part D in Idaho
How the federal Extra Help program lowers Medicare Part D costs for Idahoans, who qualifies, what it pays, and why dual-eligibles get it automatically.
Extra Help, officially the Low Income Subsidy (LIS), is the federal program that makes Medicare prescription drugs affordable for low-income beneficiaries. In 2026, full Extra Help means generic copays under $5 and brand copays under $13. It's worth applying for even if you're not sure you qualify.
Who automatically gets Extra Help in Idaho
- Anyone with full Idaho Medicaid.
- Anyone enrolled in QMB, SLMB, or QI.
- Anyone receiving SSI.
If any of these apply to you, you're already enrolled, no application needed. You should be paying no more than the Extra Help copays at the pharmacy. If you're being charged more, something is misfiled and we can fix it.
Who should apply
Anyone with Medicare and limited income or resources, even if you don't qualify for Idaho Medicaid. The income limit is roughly 150% of the federal poverty level and the asset limit is around $17,600 single / $35,130 couple, much more generous than ABD Medicaid.
What Extra Help eliminates
- The Part D late enrollment penalty, entirely waived.
- The Part D deductible.
- The coverage gap (donut hole), Extra Help recipients skip it.
- Most of your drug copays.
How to apply
Apply at ssa.gov/extrahelp or call Social Security at 1-800-772-1213. Approval typically takes 2 to 4 weeks. We can walk through the application with you in about 15 minutes.
Talk to a real person
Hometown Health is an independent Idaho Falls agency. We focus on Medicare, Medicaid, and dual-eligible coverage across Idaho.