Extra Help in New Hampshire: Medicare Part D Low-Income Subsidy
What Extra Help Does
Extra Help — formally called the Part D Low-Income Subsidy (LIS) — is a federal program that pays most of the costs of Medicare prescription drug coverage. For someone approved in 2026, Full Extra Help means:
- $0 Part D deductible (the standard deductible is $615 in 2026)
- Drug plan premium subsidized up to the New Hampshire benchmark of $21.72/month — pick a plan at or below this and the monthly premium is $0
- Prescription copays capped at $1.60 for generics and $4.90 for brand-name drugs (at income ≤ 100% FPL), or $5.10 and $12.65 (above 100% FPL)
- $0 copays after out-of-pocket spending reaches $2,100 for the year
For someone taking three or four daily medications, the savings can easily reach $3,000 to $5,000 a year.
The MSP Shortcut
Most people apply for Extra Help through Social Security, filling out SSA form SSA-1020. But in New Hampshire, there's a faster path: get approved for any Medicare Savings Program tier — QMB, SLMB, or SLMB135 — and Extra Help comes automatically.
When DHHS approves an MSP application, it sends an electronic deeming record to CMS and Social Security. That record grants Full Extra Help status without any separate paperwork. The process works in reverse too — if someone applies for Extra Help through Social Security, the Medicare Improvements for Patients and Providers Act (MIPPA) requires SSA to forward their financial data to NH DHHS, which treats it as an MSP application.
Either way, one application can unlock both programs.
When the Pharmacy Hasn't Caught Up
There's a lag between DHHS approval and the pharmacy's billing system reflecting Extra Help status. If your parent fills a prescription and the pharmacy charges full price, ask the pharmacist to apply the Best Available Evidence (BAE) policy. Show the DHHS Notice of Decision letter or the SSA deeming notice. The Part D plan is required to update the copay tier within 48 to 72 hours.
Keep a copy of the approval letter in a wallet or phone — it's the fastest way to resolve a pharmacy billing issue at the counter.
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No State Prescription Assistance Program in New Hampshire
Unlike some neighboring states, New Hampshire does not run a general State Pharmaceutical Assistance Program (SPAP) for seniors. That makes Extra Help through MSP approval the primary prescription cost relief available.
For medications not covered by a Part D formulary, two other options exist:
- New Hampshire Medication Bridge Program connects uninsured and underinsured patients with manufacturer patient assistance programs
- 340B health centers offer discounted drugs at qualifying community health centers
Neither replaces what Extra Help does for someone with Part D coverage, but they can fill gaps for specific drugs.
Checking Eligibility
The income and asset limits for Extra Help through MSP approval match the MSP limits themselves — up to $1,816/month for a single person (SLMB135 ceiling) and $9,950 in countable assets. If your parent qualifies for any MSP tier, they qualify for Full Extra Help.
Our New Hampshire Medicare Savings Programs & Extra Help Guide covers the full interaction between MSP tiers and Extra Help, including how to handle the pharmacy billing gap and what to do if a Part D plan charges above the copay cap.
Get Your Free New Hampshire — Medicare Savings Program Eligibility Checklist
Download the New Hampshire — Medicare Savings Program Eligibility Checklist — a printable guide with checklists, scripts, and action plans you can start using today.