Extra help Medicare
Medicare provides programs and benefits to many people. This includes the Extra Help Medicare program that provides qualified beneficiaries help paying their Medicare Part D monthly premium, annual deductible, coinsurance and copays for their prescription medications.
To qualify for this program, individuals must meet income requirements. Individuals who are accepted into this program do not have to pay any Part D late enrollment penalty they may have acquired.
How to apply for extra help
If you do not automatically qualify for Extra Help, you will need to apply. You must meet the following qualifications to be eligible for Extra Help.
- Applicants must have Medicare Parts A and B.
- They must reside in the U.S. or the District of Columbia.
- They do not have more than $34,360 in assets that include savings, investments & real estate if they are married, or $17,220 if they are single or not living with a spouse. If your assets are more than that, you are not eligible for Extra Help. Important; this amount does not include your home, cars or personal possessions. It also does not include life insurance, irrevocable burial contracts or back payments from Social Security or SSI.
If you meet the qualifications specified above, you can apply for Extra Help online.
For help with the online application, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
Please note: Some people do not need to apply for Extra help. If you have either Medicare and SSI (Supplemental Security Income) or Medicare and Medicaid, you do not need to apply for Extra Help. You will automatically be enrolled.
Extra Help isn’t available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa. But there are other programs available in those areas to help people with limited income and resources. Programs vary in these areas. Call your State Medical Assistance (Medicaid) office to learn more
Who can get Extra Help
If you think you meet the financial requirements and have Medicare A & B as well as are a resident of the U.S. or District of Columbia, just complete the online application. You will receive a letter notifying you if you are accepted into the program.
Important: residents of Guam, Puerto Rico, the US Virgin Islands, Northern Mariana Islands or American Samoa are not eligible for the Extra Help program. To find alternative programs in those areas, check your state’s Medicaid eligibility at Medicaid.gov to find resources.
Additional financial resources
Individual states also have financial resources available through Medicare Savings Programs for those who meet the income qualifications. Use this link to find additional information for financial help in your area.
Beneficiaries can also go to Medicare.gov or call 1-800-medicare (TTY 1-877-486-2048)to find information on financial assistance programs.
Please be aware: Extra Help is not a prescription drug plan. Beneficiaries must enroll in either an MAPD plan or a stand alone PDP plan to have coverage for prescription medications.