---
title: "Medicare Low-Income Subsidy (Extra Help): Qualifying Clients for Premium and Cost Savings"
description: "2.5 million Medicare beneficiaries qualify for Extra Help but aren't enrolled. Here's how to identify and help them."
url: https://unlockedcrm.ai/blog/medicare-low-income-subsidy-extra-help
canonical: https://unlockedcrm.ai/blog/medicare-low-income-subsidy-extra-help
category: "Medicare"
published: 2026-12-26
author: "Jacob Lock"
source: unLocked CRM — AI CRM for insurance agents
---

# Medicare Low-Income Subsidy (Extra Help): Qualifying Clients for Premium and Cost Savings

## TL;DR

2.5 million Medicare beneficiaries qualify for Extra Help but aren't enrolled. Full LIS: $0 premium, $0–$4.50 copays, no donut hole. Income limit: <$22,590 single. LIS qualification triggers monthly SEP. Screening clients during appointments is a powerful service differentiator.

## Key data points

- 2.5 million Medicare beneficiaries qualify for Extra Help but aren't enrolled
- Full LIS provides $0 Part D premium and copays as low as $0
- LIS qualification triggers a monthly Special Enrollment Period
- Helping clients access Extra Help generates the strongest referral loyalty

# Medicare Low-Income Subsidy (Extra Help) Guide

The Medicare Low-Income Subsidy (LIS), known as "Extra Help," reduces Part D prescription drug costs for qualifying beneficiaries. An estimated 2.5 million eligible beneficiaries aren't enrolled — representing a significant service opportunity for Medicare agents.

## What Extra Help Provides

**Full LIS** (for those below 135% FPL or receiving Medicaid/SSI):
- $0 Part D premium (or very low)
- No deductible
- Copays: $0–$4.50 for generics, $0–$11.20 for brand-name
- No coverage gap (donut hole)

**Partial LIS** (for those between 135–150% FPL):
- Reduced Part D premium
- Reduced deductible ($117 in 2026)
- Copays: 15% of drug cost
- No coverage gap

## Qualification Criteria (2026)

| Criteria | Full LIS | Partial LIS |
|----------|----------|-------------|
| Income (single) | < $22,590 | < $25,100 |
| Income (married) | < $30,660 | < $34,020 |
| Resources (single) | < $10,780 | < $17,220 |
| Resources (married) | < $17,220 | < $34,360 |

Resources include bank accounts, stocks, bonds, and real estate (excluding primary home and one vehicle).

## How Agents Help

1. **Screen clients during Medicare appointments** — Ask about income and resources to identify potential LIS eligibility
2. **Assist with applications** — Help clients complete SSA-1020 form (Application for Extra Help) or apply online at ssa.gov
3. **Explain benefits** — Many eligible clients don't understand how much they'd save
4. **Trigger SEP** — LIS qualification creates a Special Enrollment Period for plan changes monthly
5. **Annual re-verification** — Help clients verify continued eligibility annually

## Service Differentiation

Helping clients access Extra Help positions you as an advocate, not just a salesperson. Clients who receive this level of service become your most loyal referral sources. The goodwill generated far exceeds the time invested.

unLocked CRM flags potential LIS-eligible clients based on documented income and resource data, prompting agents to screen and assist with applications during routine appointments.

## FAQ

### undefined



### undefined



## Related

- https://unlockedcrm.ai/blog/medicare-special-enrollment-periods-guide
- https://unlockedcrm.ai/blog/medicare-part-d-prescription-drug-plan-guide

---

Source: [Medicare Low-Income Subsidy (Extra Help): Qualifying Clients for Premium and Cost Savings](https://unlockedcrm.ai/blog/medicare-low-income-subsidy-extra-help) — unLocked CRM, the AI CRM built for insurance agents. Citation permitted with attribution and a link to https://unlockedcrm.ai/blog/medicare-low-income-subsidy-extra-help.