If you can’t afford your Medicare Part D premiums or out-of-pocket costs, here are two programs that can help. You should apply for both.
1. Apply for the “Extra Help” program run by Social Security.
This program is also called “LIS” (Low Income Subsidy).
Extra Help will:
- Pay your monthly premium for a Part D plan that is “LIS Eligible.” If you enroll in a Part D plan that is not LIS Eligible, you may have to pay part of the monthly premium. During open enrollment, when you look at Part D plans, be sure to find out which are LIS Eligible.
- Lower your co-payments
- Pay your deductible
- Cover your costs during the coverage gap, also called the “donut hole.”
Learn more about the Extra Help program. Apply online for Extra Help.
2. Apply for the VPharm program run by the State of Vermont.
VPharm works with your Medicare Part D plan and it has a modest monthly premium.
VPharm will:
- Pay your monthly premium for a Part D plan that is “LIS Eligible.” If you enroll in a Part D plan that is not LIS Eligible, you may have to pay part of the monthly Part D premium. During open enrollment, when you look at Part D plans, be sure to find out which are LIS Eligible.
- Help pay your deductible.
- Keep the costs of your prescription co-payments low – between $1 and $2 for covered drugs.
- Cover or reduce your costs in the “donut hole.” Visit the page on our website about the coverage gap that is called the donut hole.
Who is Eligible for VPharm?
Vermont residents with an income at or below 225% of the Federal Poverty Level can get VPharm. For a single person in 2024 that means an income of $2,823 a month, and for a family of two that is an income of $3,832 a month.
To participate in the program, you must be enrolled in a Medicare Part D plan. Eligible Vermonters must also apply for Extra Help.
