The Extra Help Program for Medicare Part D

Author: OncoLink Team
Content Contributor: Christina Bach, MBE, MSW, LCSW, OSW-C
Last Reviewed:

Extra Help (Low Income Subsidy) is a program run by the Social Security Administration (SSA). It provides help to pay for your Medicare Part D premiums (monthly cost), deductibles and co-payments.

To qualify for Extra Help you must:

  • Live in one of the 50 states or the District of Columbia.
  • Have Medicare Part A and Part B
  • Have limited financial resources. For a single person, the resource limit is $14,610. For a married couple, the resource limit is $29,160.
    • Resources include money in bank accounts, stocks, and bonds.
    • Resources do not include your home, car, burial plots, or life insurance.
    • Your income must also be limited. The income limit for a single person is $19, 140 per year. The income limit for a married couple who lives together is $25, 860 per year. This income could be what you receive from social security or pension.
    • There may be some exceptions to these income limits if you:
      • Support other family members who are living with you.
      • Additional income you may have from the work you do.
      • Live in Alaska or Hawaii, as the standard cost of living is higher in these states.

How do I apply?

What happens once I’m approved?

  • You still need to pick a Medicare part D plan. If you don’t, the Centers for Medicare and Medicaid Services will pick it for you. You can search for plans in your area at www.medicare.gov or call 1-800-MEDICARE for help.
  • If you are approved for Extra Help, your costs are no more then $3.35 for each generic prescription and $8.35 for each brand name prescription (if the medicine is covered by the plan).
  • You may also want to apply for Medicare Savings Programs. These programs can help you with your Medicare Part B premiums. For some people, the Medicare Savings Program also covers Part A premiums and Part A and B deductibles and copayments. Each state has its own rules for these programs. SSA will send information to your state’s Medicaid office to help you apply for a Medicare Savings Program.

If you meet the requirements for Extra Help, apply today! It can save you a lot of money on prescription costs. If you need help applying, ask your healthcare provider, social worker, or navigator.

For more insurance information, listen to our Health Insurance Webinar Series.

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