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Extra Help with Prescription Drug (Part D) Costs

Even with a Medicare Prescription Drug Plan (Part D), lower income seniors might find that the premiums, deductibles and co-pays for prescription drugs are too expensive to afford.    Extra Help is a Medicare program that is designed to assist people with these drug costs, and it is estimated that it may save many people, on average, about $4,000 per year on prescriptions premiums, deductibles, and coinsurance.

In order to qualify for Extra Help (in 2015), you must meet the following criteria:

  • You must reside in one of the 50 states or the District of Columbia
  • Your resources must be limited to $13,640 for an individual or $27,250 for a married couple who is living together. (Resources include such things as bank accounts, stocks and bonds. Medicare does not include items such as your home, car, or any life insurance policies).
  • Your annual income must be limited to $17,655 for an individual or $23,895 for a married couple living together. (Even if your annual income is higher, you may still be able to get some help. Some examples of where you may have higher income and still qualify include if you or your spouse support other family members who live with you, or you have earnings from work, or you live in Hawaii or Alaska).

It is important to note that these amounts may change annually, so be sure to check the qualification factors each year.

Some people are automatically enrolled in Extra Help.  They get a purple notice that tells them that they are deemed eligible without even applying, usually because:

  • They’re “dual eligible,”  i.e., they are in both Medicare and Medicaid.
  • They are in a Medicare Savings Program.
  • They collect Supplemental Security Income (SSI) benefits.

If you’re not automatically enrolled in Extra Help, applying for it is easy. This can be done by going to the Social Security website and applying online at www.socialsecurity.gov/extrahelp or by contacting Social Security via phone at 1-800-772-1213. You may also apply at your local Social Security office.

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