Medicare Part D Extra Help (Low-Income Subsidy for drug costs): who qualifies, what you get, how to apply, and what happens next
Extra Help is the federal program that pays most Medicare drug plan costs for people with limited income and resources: in 2027 a $0 premium and deductible and small copays. People with Medi-Cal, SSI or a Medicare Savings Program get it automatically; others apply to Social Security online, by phone or at an office.
What Extra Help is, in one paragraph
Extra Help, also called the Low-Income Subsidy, is a federal Medicare program run by Social Security that pays most of the cost of Medicare drug coverage (Part D): the monthly premium, the deductible and most of each prescription. A person with Extra Help also never pays the Part D late enrollment penalty (rule:definition). Social Security estimates it is worth about $5,700 a year (rule:value_estimate). People who get full Medi-Cal, Supplemental Security Income, or a Medicare Savings Program get it automatically; everyone else applies (rule:automatic).
$0
plan premium and plan deductible for a person with Extra Help in 2027, with copays up to $5.80 generic and $14.40 brand (Medicare.gov, rule:costs_2027)
Who may qualify
Automatic: full-benefit Medi-Cal, SSI, or a Medicare Savings Program (rule:automatic).
By application: income and resources below the 2026 limits (rule:income_limit_2026, rule:resource_limit_2026):
Yearly income limit
Resource limit
One person
$23,940
$18,090
Married couple living together
$32,460
$36,100
Income above the limit can still qualify when the person supports family members living with them or has earnings from work. Resources are savings, investments and real estate other than the home; the home, vehicles, personal possessions, life insurance and burial funds do not count. Income does not include SNAP, housing or energy assistance, EITC payments, disaster aid or help from others with household bills (rule:income_exclusions).
What it pays in 2027: $0 plan premium, $0 deductible, up to $5.80 for a generic and $14.40 for a brand-name drug, and $0 once total drug costs reach $2,400. A person with full Medi-Cal and QMB pays no more than $4.90 per drug (rule:costs_2027). Extra Help is not available in the five U.S. territories (rule:territories).
How to apply, and what happens after
Apply any time, before or after joining a drug plan, on form SSA-1020: online, by phone at 1-800-772-1213 (TTY 1-800-325-0778), or at a local Social Security office (rule:apply_any_time, rule:contact). No documents are required to file; Social Security matches the figures against other agencies' records. The application also starts a Medicare Savings Program application with the state unless the person says no (rule:msp_referral).
If records show the person is ineligible, Social Security first sends a pre-decisional notice; the person has 10 days to call or visit with correct information (rule:predecisional_10). After approval, a person without a drug plan is enrolled in one and can switch; Extra Help lasts through 31 December even if income changes (rule:auto_plan), and drug coverage can be changed once a month (rule:monthly_switch). LI NET covers prescriptions before a plan starts (rule:li_net).
Each year Social Security reviews some people, usually at the end of August, with form SSA-1026; it must be returned within 30 days or Extra Help stops the next year (rule:annual_review). A person who did not qualify can reapply any time (rule:reapply_any_time).
Disagree with the decision? Appeal within 60 days of receiving the notice on form SSA-1021 (rule:appeal_60).
The procedure, stage by stage, as data
JSONThe procedure, stage by stage, as data
[12 items
{10 keys
"id": "stage:discover",
"order": 1,
"name": "Discover",
"what_happens": "A person with Medicare learns Extra Help pays most Part D costs and that Medi-Cal, SSI or a Medicare Savings Program makes it automatic",
"who_acts": "Person / SHIP counselors",
"timeline": "No deadline; apply any time",
"evidence": "None",
"failure_mode": "Not knowing Extra Help exists, and paying full drug costs",
"model_role": "State the 2026 limits and the 2027 copays",
"automation_class": "A"
},{10 keys
"id": "stage:screen_eligibility",
"order": 2,
"name": "Screen eligibility",
"what_happens": "Automatic routes first; then yearly income and resources against the 2026 limits",
"who_acts": "Model + person",
"timeline": "Minutes",
"evidence": "Income, resources, current benefits",
"failure_mode": "Counting the home, car or excluded income",
"model_role": "Apply the exclusions before comparing to the limits",
"automation_class": "A"
},{10 keys
"id": "stage:gather_documents",
"order": 3,
"name": "Gather documents",
"what_happens": "Income and resource figures for the person and a spouse living with them; no documents are needed to file",
"who_acts": "Person",
"timeline": "Before applying",
"evidence": "Statements kept for reference",
"failure_mode": "Delaying the application to collect papers",
"model_role": "Tell the person the application asks for figures, not documents",
"automation_class": "A"
},{10 keys
"id": "stage:complete_application",
"order": 4,
"name": "Complete application",
"what_happens": "Form SSA-1020, online, by phone or at an office",
"who_acts": "Person / family / third party",
"timeline": "One sitting",
"evidence": "SSA-1020",
"failure_mode": "Answering for the helper instead of the applicant",
"model_role": "Walk through the questions",
"automation_class": "A"
},{10 keys
"id": "stage:submit",
"order": 5,
"name": "Submit",
"what_happens": "Submit online or by phone; the state is told to start a Medicare Savings Program application unless the person declines",
"who_acts": "Person",
"timeline": "Same day",
"evidence": "Confirmation",
"failure_mode": "Declining the MSP referral by mistake",
"model_role": "Explain the MSP checkbox",
"automation_class": "A"
},{10 keys
"id": "stage:interview_verification",
"order": 6,
"name": "Interview / verification",
"what_happens": "Social Security matches the figures with other agencies' data; a pre-decisional notice is sent if records show ineligibility",
"who_acts": "Social Security",
"timeline": "10 days to answer a pre-decisional notice",
"evidence": "Pre-decisional notice",
"failure_mode": "Not answering within 10 days",
"model_role": "Give the 10-day deadline",
"automation_class": "B"
},{10 keys
"id": "stage:decision",
"order": 7,
"name": "Decision",
"what_happens": "Notice of the decision; a person without a drug plan is enrolled in one",
"who_acts": "Social Security / Medicare",
"timeline": "After review",
"evidence": "Decision notice",
"failure_mode": "Not reading which plan was assigned",
"model_role": "Read the notice back",
"automation_class": "A"
},{10 keys
"id": "stage:issuance_use",
"order": 8,
"name": "Issuance / use",
"what_happens": "Lower premiums and copays at the pharmacy; LI NET covers the gap before a plan starts",
"who_acts": "Plan / pharmacy",
"timeline": "Through 31 December of the year",
"evidence": "Plan card, Extra Help notice",
"failure_mode": "Paying the wrong copay at the pharmacy",
"model_role": "Show what to say to the plan and Medicare",
"automation_class": "D"
},{10 keys
"id": "stage:report_changes",
"order": 9,
"name": "Report changes",
"what_happens": "Extra Help continues through 31 December even if income changes; a person who did not qualify can reapply any time",
"who_acts": "Person",
"timeline": "Any time",
"evidence": "New figures",
"failure_mode": "Not reapplying after income drops",
"model_role": "Prompt a reapplication after a drop in income",
"automation_class": "A"
},{10 keys
"id": "stage:renew_recertify",
"order": 10,
"name": "Renew / recertify",
"what_happens": "Selected people get review form SSA-1026, usually at the end of August",
"who_acts": "Person / Social Security",
"timeline": "Return within 30 days; changes start in January",
"evidence": "SSA-1026",
"failure_mode": "Not returning the form ends Extra Help the next year",
"model_role": "Remind the person to return the form",
"automation_class": "B"
},{10 keys
"id": "stage:denial_response",
"order": 11,
"name": "Denial response",
"what_happens": "Read the final determination",
"who_acts": "Person",
"timeline": "Immediately",
"evidence": "Determination notice",
"failure_mode": "Letting the 60 days pass",
"model_role": "Name the deadline",
"automation_class": "A"
},{10 keys
"id": "stage:appeal_fair_hearing",
"order": 12,
"name": "Appeal / fair hearing",
"what_happens": "Form SSA-1021 to Wilkes-Barre; hearing by phone or by case review; then federal court",
"who_acts": "Person / Social Security",
"timeline": "Within 60 days of receiving the notice",
"evidence": "SSA-1021",
"failure_mode": "Missing the deadline",
"model_role": "State the address and deadline",
"automation_class": "B"
}
]
The same facts open other programs
Yearly income, resources and Medicare status are the facts Extra Help runs on; the same facts open the state programs that pay Medicare premiums.
Appeal by mail: Form SSA-1021 to Wilkes-Barre Data Operations Center, P.O. Box 1030, Wilkes-Barre, PA 18767-1030
Phone: Social Security 1-800-772-1213 (TTY 1-800-325-0778); Medicare 1-800-633-4227 (TTY 1-877-486-2048); LI NET 1-800-783-1307 (rule:contact, rule:li_net)
Help with drug costs: Extra Help — Medicare.gov (Centers for Medicare & Medicaid Services)“You also won't have to pay a Part D late enrollment penalty while you get Extra Help.”
Help with drug costs: who gets it automatically — Medicare.gov (Centers for Medicare & Medicaid Services)“Some people qualify for Extra Help automatically, and other people have to apply.”
Help with drug costs: MSP application — Medicare.gov (Centers for Medicare & Medicaid Services)“Social Security will send information to your state to initiate an MSP application unless you tell them not to on the Extra Help application.”
Help with drug costs: through December 31 — Medicare.gov (Centers for Medicare & Medicaid Services)“Even if your income changes in the middle of the year, you’ll keep getting Extra Help through December 31.”
Help with drug costs: change plans — Medicare.gov (Centers for Medicare & Medicaid Services)“If you have Medicaid or get Extra Help, you may be able to change your drug coverage once per month.”
Help with drug costs: LI NET — Medicare.gov (Centers for Medicare & Medicaid Services)“call LI NET at 1-800-783-1307”
Help with drug costs: reapply — Medicare.gov (Centers for Medicare & Medicaid Services)“Even if you don’t qualify for Extra Help now, you can reapply for Extra Help any time if your income and resources change.”
Help with drug costs: territories — Medicare.gov (Centers for Medicare & Medicaid Services)“Extra Help isn't available in Puerto Rico”
Understanding the Extra Help (05-10508): appeal — Social Security Administration“You have 60 days from the date you receive the notice telling you about our decision to request an appeal.”
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"title":"Medicare Part D Extra Help (Low-Income Subsidy for drug costs): who qualifies, what you get, how to apply, and what happens next",
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"summary":"Extra Help is the federal program that pays most Medicare drug plan costs for people with limited income and resources: in 2027 a $0 premium and deductible and small copays. People with Medi-Cal, SSI or a Medicare Savings Program get it automatically; others apply to Social Security online, by phone or at an office.",
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{
"id":"stage:decision",
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"failure_mode":"Not reading which plan was assigned",
"model_role":"Read the notice back",
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{
"id":"stage:issuance_use",
"order":8,
"name":"Issuance / use",
"what_happens":"Lower premiums and copays at the pharmacy; LI NET covers the gap before a plan starts",
"who_acts":"Plan / pharmacy",
"timeline":"Through 31 December of the year",
"evidence":"Plan card, Extra Help notice",
"failure_mode":"Paying the wrong copay at the pharmacy",
"model_role":"Show what to say to the plan and Medicare",
"automation_class":"D"
},
{
"id":"stage:report_changes",
"order":9,
"name":"Report changes",
"what_happens":"Extra Help continues through 31 December even if income changes; a person who did not qualify can reapply any time",
"who_acts":"Person",
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{
"id":"stage:renew_recertify",
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"who_acts":"Person / Social Security",
"timeline":"Return within 30 days; changes start in January",
"evidence":"SSA-1026",
"failure_mode":"Not returning the form ends Extra Help the next year",
"model_role":"Remind the person to return the form",
"automation_class":"B"
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{
"id":"stage:denial_response",
"order":11,
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"model_role":"Name the deadline",
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{
"id":"stage:appeal_fair_hearing",
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"who_acts":"Person / Social Security",
"timeline":"Within 60 days of receiving the notice",
"evidence":"SSA-1021",
"failure_mode":"Missing the deadline",
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"stage:issuance_use",
"stage:report_changes",
"stage:renew_recertify",
"stage:denial_response",
"stage:appeal_fair_hearing"
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"rules": [
{
"id":"rule:definition",
"kind":"definition",
"text":"Extra Help is a Medicare program that helps people with limited income and resources pay Medicare drug coverage (Part D) premiums, deductibles, coinsurance and other costs. A person with Extra Help pays no Part D late enrollment penalty.",
"jurisdiction":"US",
"source":"s_mgov_xh_penalty",
"status":"verified 2026-10-09"
},
{
"id":"rule:automatic",
"kind":"categorical",
"text":"A person gets Extra Help automatically, without applying, if they get full-benefit Medicaid (Medi-Cal), help from the state paying Part B premiums through a Medicare Savings Program, or Supplemental Security Income. Everyone else applies.",
"jurisdiction":"US",
"source":"s_mgov_xh_auto",
"status":"verified 2026-10-09"
},
{
"id":"rule:income_limit_2026",
"kind":"income_test",
"text":"Annual income limit in 2026. A person with higher income may still qualify, for example when supporting family members who live with them, having earnings from work, or living in Alaska or Hawaii.",
"jurisdiction":"US",
"effective":"2026",
"values_usd_annual": {
"individual":23940,
"married_couple_living_together":32460
},
"source":"s_ssa_pub_income",
"status":"verified 2026-10-09 (Medicare.gov 2026 table and SSA publication 05-10508, August 2026, agree)"
},
{
"id":"rule:resource_limit_2026",
"kind":"asset_test",
"text":"Resource limit in 2026. Resources are savings, investments and real estate other than the home; the home, personal possessions, vehicles, life insurance, burial expenses and property needed for self-support are not counted.",
"jurisdiction":"US",
"effective":"2026",
"values_usd": {
"individual":18090,
"married_couple_living_together":36100
},
"source":"s_ssa_pub_resources",
"status":"verified 2026-10-09 (Medicare.gov 2026 table and SSA publication 05-10508 agree)"
},
{
"id":"rule:income_exclusions",
"kind":"deduction",
"text":"Not counted as income: SNAP (food stamps), housing assistance, home energy assistance, medical treatment and drugs, disaster assistance, earned income tax credit payments, help from others paying household expenses, victim compensation, scholarships and education grants.",
"jurisdiction":"US",
"source":"s_ssa_pub_exclusions",
"status":"verified 2026-10-09"
},
{
"id":"rule:costs_2027",
"kind":"benefit",
"text":"What a person with Extra Help pays in 2027: plan premium $0, plan deductible $0, up to $5.80 for each generic drug and up to $14.40 for each brand-name drug at a participating pharmacy, and $0 per covered drug once total drug costs reach $2,400. A person who also has full Medicaid and QMB pays no more than $4.90 per covered drug.",
"jurisdiction":"US",
"effective":"2027",
"values_usd": {
"plan_premium":0,
"plan_deductible":0,
"generic_max":5.8,
"brand_max":14.4,
"catastrophic_threshold_total_drug_costs":2400,
"after_threshold":0,
"medicaid_and_qmb_max_per_drug":4.9
},
"source":"s_mgov_xh_2027",
"status":"verified 2026-10-09"
},
{
"id":"rule:value_estimate",
"kind":"benefit",
"text":"Social Security estimates Extra Help is worth about $5,700 per year.",
"jurisdiction":"US",
"value_usd_annual":5700,
"source":"s_ssa_pub_worth",
"status":"verified 2026-10-09"
},
{
"id":"rule:apply_any_time",
"kind":"procedure",
"text":"Apply any time, before or after enrolling in Part D, with form SSA-1020: online, by phone, or at a local Social Security office.",
"jurisdiction":"US",
"source":"s_ssa_apply",
"status":"verified 2026-10-09"
},
{
"id":"rule:msp_referral",
"kind":"procedure",
"text":"An Extra Help application also starts a Medicare Savings Program application: Social Security sends the information to the state unless the applicant says no.",
"jurisdiction":"US",
"source":"s_mgov_xh_msp",
"status":"verified 2026-10-09"
},
{
"id":"rule:auto_plan",
"kind":"issuance",
"text":"A person who qualifies and has no drug plan is enrolled in one automatically and may pick a different plan. Extra Help lasts through 31 December even if income changes during the year.",
"jurisdiction":"US",
"source":"s_mgov_xh_dec31",
"status":"verified 2026-10-09"
},
{
"id":"rule:monthly_switch",
"kind":"procedure",
"text":"A person with Medicaid or Extra Help may be able to change drug coverage once per month.",
"jurisdiction":"US",
"source":"s_mgov_xh_switch",
"status":"verified 2026-10-09"
},
{
"id":"rule:li_net",
"kind":"issuance",
"text":"The Limited Income Newly Eligible Transition (LI NET) program gives temporary Part D coverage to people who qualify for Extra Help or Medicaid but are not yet in a drug plan, and may repay covered drugs bought after qualifying.",
"jurisdiction":"US",
"phones": {
"li_net":"1-800-783-1307"
},
"source":"s_mgov_xh_linet",
"status":"verified 2026-10-09"
},
{
"id":"rule:annual_review",
"kind":"renewal",
"text":"Social Security reviews eligibility every year, usually at the end of August, for people selected for review. The review form SSA-1026 must be returned within 30 days; changes take effect the following January. Not returning it ends Extra Help the following year.",
"jurisdiction":"US",
"value_days":30,
"source":"s_ssa_pub_review",
"status":"verified 2026-10-09"
},
{
"id":"rule:reapply_any_time",
"kind":"renewal",
"text":"A person who does not qualify now can reapply any time income and resources change.",
"jurisdiction":"US",
"source":"s_mgov_xh_reapply",
"status":"verified 2026-10-09"
},
{
"id":"rule:predecisional_10",
"kind":"deadline",
"text":"When Social Security's records show a person is ineligible, it sends a pre-decisional notice. The person has 10 days from receiving it to call or visit and correct the information before a final determination is sent.",
"jurisdiction":"US",
"value_days":10,
"source":"s_ssa_pub_predecision",
"status":"verified 2026-10-09"
},
{
"id":"rule:appeal_60",
"kind":"appeal",
"text":"A final determination can be appealed within 60 days of receiving the notice, on form SSA-1021 mailed to the Wilkes-Barre Data Operations Center, P.O. Box 1030, Wilkes-Barre, PA 18767-1030, or at a local office. The hearing is usually by phone or by case review. Good cause can extend the deadline. After the appeal, a person may file in federal district court.",
"jurisdiction":"US",
"value_days":60,
"source":"s_ssa_pub_appeal",
"status":"verified 2026-10-09"
},
{
"id":"rule:territories",
"kind":"restriction",
"text":"Extra Help is not available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands or American Samoa.",
"jurisdiction":"US",
"source":"s_mgov_xh_territories",
"status":"verified 2026-10-09"
},
{
"id":"rule:contact",
"kind":"administration",
"text":"Social Security and Medicare phone numbers for Extra Help.",
"jurisdiction":"US",
"phones": {
"social_security":"1-800-772-1213",
"social_security_tty":"1-800-325-0778",
"medicare":"1-800-633-4227",
"medicare_tty":"1-877-486-2048"
},
"source":"s_ssa_apply_phone",
"status":"verified 2026-10-09"
}
],
"fiscal_year": {
"fiscal_year":"Calendar year 2026 (limits); 2027 (costs)",
"effective":"2026-01-01 to 2026-12-31",
"source":"s_ssa_pub_income",
"area":"United States except Alaska and Hawaii (higher limits there) and the five territories"
},
"fields": [
{
"field_id":"f:medicare",
"canonical_fact":"person.health.medicare.parts_enrolled",
"label":"Do you have Medicare (Part A or Part B), and a Part D drug plan",
"data_type":"list",
"required":true,
"sensitivity":"sensitive",
"used_by_rules": [
"rule:definition",
"rule:auto_plan",
"rule:li_net"
]
},
{
"field_id":"f:currently_receiving",
"canonical_fact":"benefits.currently_receiving[]",
"label":"Do you get Medi-Cal, SSI, or a Medicare Savings Program",
"data_type":"list",
"required":true,
"sensitivity":"sensitive",
"used_by_rules": [
"rule:automatic"
]
},
{
"field_id":"f:married",
"canonical_fact":"household.composition.members[]",
"label":"Single, or married and living with a spouse; family members who live with you and whom you support",
"data_type":"enum",
"required":true,
"sensitivity":"personal",
"used_by_rules": [
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},
{
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"title":"Extra Help: ask the article",
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"starters": [
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"Am I under the income and savings limits?",
"What will my prescriptions cost with Extra Help?",
"How do I appeal an Extra Help decision?",
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}
],
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"instructions":"You are helping one person or couple with Medicare Part D Extra Help. Use only the rules in this article's facts.rules, naming the rule id and its source id beside every figure; the income and resource limits are for 2026 (rule:income_limit_2026, rule:resource_limit_2026) and the costs are for 2027 (rule:costs_2027). Check the automatic routes first (rule:automatic): Medi-Cal, SSI, or a Medicare Savings Program. Then ask for yearly income and countable resources, applying the exclusions (rule:income_exclusions) before comparing. Report results as: potentially eligible, potentially ineligible, insufficient information, or requires Social Security determination; always say Social Security decides. Ask for at most two facts at a time and restate each as a canonical fact line (household.assets.countable = 9000). Give the next step (rule:apply_any_time), the 10-day pre-decisional deadline (rule:predecisional_10) and the 60-day appeal deadline (rule:appeal_60) when relevant. Use facts.ontology.related_programs to name other programs the same facts open. Never claim an application was filed. Keep it short.",
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},
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},
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"## What Extra Help is, in one paragraph\n\nExtra Help, also called the Low-Income Subsidy, is a federal Medicare program run by Social Security that pays most of the cost of Medicare drug coverage (Part D): the monthly premium, the deductible and most of each prescription. A person with Extra Help also never pays the Part D late enrollment penalty (rule:definition). Social Security estimates it is worth about $5,700 a year (rule:value_estimate). People who get full Medi-Cal, Supplemental Security Income, or a Medicare Savings Program get it automatically; everyone else applies (rule:automatic).",
{
"type":"stat",
"value":"$0",
"label":"plan premium and plan deductible for a person with Extra Help in 2027, with copays up to $5.80 generic and $14.40 brand (Medicare.gov, rule:costs_2027)"
},
"## Who may qualify\n\n**Automatic**: full-benefit Medi-Cal, SSI, or a Medicare Savings Program (rule:automatic).\n\n**By application**: income and resources below the 2026 limits (rule:income_limit_2026, rule:resource_limit_2026):\n\n| | Yearly income limit | Resource limit |\n|---|---|---|\n| One person | $23,940 | $18,090 |\n| Married couple living together | $32,460 | $36,100 |\n\nIncome above the limit can still qualify when the person supports family members living with them or has earnings from work. **Resources** are savings, investments and real estate other than the home; the home, vehicles, personal possessions, life insurance and burial funds do not count. **Income** does not include SNAP, housing or energy assistance, EITC payments, disaster aid or help from others with household bills (rule:income_exclusions).\n\n**What it pays in 2027**: $0 plan premium, $0 deductible, up to $5.80 for a generic and $14.40 for a brand-name drug, and $0 once total drug costs reach $2,400. A person with full Medi-Cal and QMB pays no more than $4.90 per drug (rule:costs_2027). Extra Help is not available in the five U.S. territories (rule:territories).",
"## What the model on this page can do for you\n\nThis article is also the context of a model you can text or chat with. The buttons under the title open Messages with a note already written, or a chat on this page. The model has read this exact page: the rules above with their source ids, the procedure below, and the other programs the same facts open. It asks for one or two facts at a time, starting with whether you get Medi-Cal, SSI or a Medicare Savings Program, then yearly income and savings, tells you whether you are likely automatic, likely eligible by application, or over the limits, and gives the exact next step. It has no tools: it cannot apply for you, and it says so. Every message is kept on this build's Ledger.\n\nA screening here is a screening, not a decision. Social Security decides.",
"## How to apply, and what happens after\n\nApply any time, before or after joining a drug plan, on form SSA-1020: **[online](https://www.ssa.gov/medicare/part-d-extra-help)**, by phone at 1-800-772-1213 (TTY 1-800-325-0778), or at a local Social Security office (rule:apply_any_time, rule:contact). No documents are required to file; Social Security matches the figures against other agencies' records. The application also starts a Medicare Savings Program application with the state unless the person says no (rule:msp_referral).\n\nIf records show the person is ineligible, Social Security first sends a **pre-decisional notice**; the person has **10 days** to call or visit with correct information (rule:predecisional_10). After approval, a person without a drug plan is enrolled in one and can switch; Extra Help lasts through 31 December even if income changes (rule:auto_plan), and drug coverage can be changed once a month (rule:monthly_switch). LI NET covers prescriptions before a plan starts (rule:li_net).\n\n**Each year** Social Security reviews some people, usually at the end of August, with form SSA-1026; it must be returned within **30 days** or Extra Help stops the next year (rule:annual_review). A person who did not qualify can reapply any time (rule:reapply_any_time).\n\n**Disagree with the decision?** Appeal within **60 days** of receiving the notice on form SSA-1021 (rule:appeal_60).",
{
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"## The same facts open other programs\n\nYearly income, resources and Medicare status are the facts Extra Help runs on; the same facts open the state programs that pay Medicare premiums.\n\n- **Medicare Savings Programs (QMB / SLMB / QI / QDWI) (B013)**: [[california-medicare-savings-programs]]. A Medicare Savings Program makes Extra Help automatic, and an Extra Help application starts one.\n- **Medi-Cal (Medicaid) (B011)**: [[california-medi-cal]]. Full-benefit Medi-Cal makes Extra Help automatic.\n- **SSI + California SSP (B023)**: [[california-ssi-ssp]]. SSI makes Extra Help automatic.\n- **CalFresh (SNAP) (B001)**: [[california-calfresh]]. SNAP is not counted as income for Extra Help, and the same income screens for CalFresh.",
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"## How this page works\n\nThis page is one JSON object. The page, the Markdown and the machine copy at [/a/california-medicare-extra-help.json](https://miscsubjects.com/a/california-medicare-extra-help.json) are three views of it. Its `facts` carry the article's identity and jurisdiction, the procedure with its stages, every rule with its source id and verification status, the fields a screening asks for with their canonical fact names, the ontology edges into the benefits graph, the declared actions, the model's instructions, and the permissions the model has (none). The model's context is served separately at [/a/california-medicare-extra-help/context](https://miscsubjects.com/a/california-medicare-extra-help/context): the same object, projected for a model, so there is one source of truth for the reader and the machine.\n\nWhat is saved: a thread per phone number that texts, holding which articles it asked about, how many messages, and the facts it stated, so a person who comes back continues rather than restarts. Every message, in either direction, is a row on this build's Ledger.\n\nFigures carry their status in `facts.rules[].status`. The 2026 limits and 2027 costs were fetched from Medicare.gov on 9 October 2026 and agree with Social Security publication 05-10508 (August 2026), which Social Security's servers serve only to a browser and was read in a browser on the Mac.",
"## Official addresses\n\n- Apply: [Social Security Extra Help application](https://www.ssa.gov/medicare/part-d-extra-help)\n- The program, limits and 2027 costs: [Medicare.gov help with drug costs](https://www.medicare.gov/basics/costs/help/drug-costs)\n- The full rules, review and appeal: [SSA publication 05-10508 (PDF)](https://www.ssa.gov/pubs/EN-05-10508.pdf)\n- Appeal by mail: Form SSA-1021 to Wilkes-Barre Data Operations Center, P.O. Box 1030, Wilkes-Barre, PA 18767-1030\n- Phone: Social Security 1-800-772-1213 (TTY 1-800-325-0778); Medicare 1-800-633-4227 (TTY 1-877-486-2048); LI NET 1-800-783-1307 (rule:contact, rule:li_net)"
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