Extra Help is a Medicare program which helps people with limited income and resources to pay for prescription drug costs. If you qualify, you could get help paying for Medicare Part D premiums, annual deductibles, and prescription drug copays or coinsurance. According to Social Security Administration (SSA), Extra Help is estimated to be worth about $5,000 per year.
Social Security will review your income and resources to determine if you are eligible. In 2021, if your income is limited to $19,320 for an individual ($26,130 for a married couple living together) AND your resources are limited to $14,790 for an individual ($29,520 for a married couple living together), you may qualify for Extra Help. Note: Income and resource limits may change each year.
You are automatically eligible for Extra Help if:
- You are eligible to receive both Medicare and Medicaid (dual eligibility)
- You have a Medicare Savings program (partial dual eligibility)
- You receive Supplemental Security Income (SSI) benefits but not Medicaid
Click here for the Social Security Administration's publication "Understanding The Extra Help With Your Medicare Prescription Drug Plan".
Click here for more information about Medicare's Extra Help program.
Click on Plan Year 2021 for a summary of monthly plan premiums for those eligible for extra help.
Applying for Extra Help with Medicare
In most cases, you will need to apply for Extra Help either through the Social Security Administration or through your state Medicaid Office. After you apply, Social Security will review your application and will send you a letter to let you know if you qualify for Extra Help.
For more information or to apply:
- Visit your local Social Security Office.
- Call the Social Security Administration toll-free at 1-800-772-1213, between 7 a.m. and 7 p.m. Monday through Friday. TTY users should call 1-800-325-0778.
- Visit the Social Security Administration's website.
Extra Help Application Forms are available by calling the Social Administration and by visiting the Social Security Administration's website.
Records you will need to complete the Extra Help Application include:
- Statements that show your account balances at banks, credit unions or other financial institutions;
- Investment statements and stock certificates;
- Tax returns;
- Pension award letters; and
- Payroll slips.
Using the Best Available Evidence Policy (BAE)
If your Extra Help information is incorrect, you can use the Best Available Evidence (BAE) policy to show that you qualify. You can use such evidence as your award letter from Social Security Administration, your Medicaid card or other proof of your eligibility for Extra Help. When you provide this information to your Medicare Prescription Drug Plan, your plan will update your Extra Help information as soon as possible.