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Enhance the Medicare Part D Extra Help program

In accordance with the Inflation Reduction Act, signed into law in August 2022, the income guidelines for the Extra Help program will increase to allow people with an income of up to 150 percent of the federal poverty limit to qualify for help, beginning in 2024.

PAN’S POSITION

The Medicare Part D Low-Income Subsidy (LIS) program—also known as the Extra Help program—should be further enhanced to increase awareness and enrollment.

Congress and the administration should further enhance the LIS program, also known as Extra Help, to help more patients, eliminate cost-sharing for generic drugs, and facilitate the enrollment process. Increased efforts to ensure more people are aware of the program are needed.

The Extra Help program’s eligibility criteria requires patients to have an income under 150 percent of the federal poverty level. Because the income limits are low, millions of Medicare beneficiaries who are economically insecure are ineligible for extra help with their out-of-pocket medication costs.

The program also requires cost-sharing for generic drugs, and the application process is complicated, leaving many to miss out on support altogether. Lastly, many eligible patients do not enroll because of the program’s complexity. Specific efforts to ensure the program reaches the people who need it most are essential.