Need Help with Prescription Drugs? Medicare’s Extra Help Program Offers Relief

The Extra Help Program is a Medicare program to help people with limited income and resources pay for prescription drug costs, like premiums, deductibles, and co-insurance.

Qualifying for the Extra Help Program means that you will get help with:

  • Paying your Medicare Part D drug plan’s monthly premium
  • Avoiding the Part D donut hole coverage gap
  • Avoiding the Part D late enrollment penalty
  • Switching your Part D drug plan at any time

How Do I Qualify?

In 2018, you may qualify if your income is less than $18,210 ($24,690 for a married couple) and up to $14,100 in resources ($28,150 for a married couple).

Resources include:

  • Money in a checking or savings account
  • Stocks
  • Bonds

Resources not included:

  • Your home
  • One car
  • Burial plot
  • Up to $1,500 for burial expenses if you have put that money aside
  • Furniture
  • Other household and personal items 

The amount of Extra Help that you are entitled to depends on your income level.  Check out this useful chartfrom the Medicare Rights Center. The Medicare website also offers help to check the level of Extra Help you’re entitled to.

 You automatically qualify for Extra Help if you have Medicare and meet any of these conditions:

  • You have full Medicaid coverage.
  • You have a Medicare Savings Program, which provides help paying your Part B premiums.
  • You get Supplemental Security Income (SSI) benefits.

You may automatically qualify for Medicare’s Extra Help program, in which case you should receive notification via snail mail. If you didn’t automatically qualify for Extra Help, you can apply online at socialsecurity.gov/i1020or call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.

If you do not qualify for the Extra Help program you may qualify for:


What If I’m Not Already Enrolled in a Medicare Program?

In order to qualify for the Extra Help program, you must purchase a Medicare Part D drug plan if you’re not already enrolled in one. Choosing a Medicare plan can be confusing at times, but our Quick Guide to Medicareis an easy way to learn the basics. Or, register for our upcoming webinar on Medicare.

Samantha Skelton
ss@triagecancer.org