It’s Easy to Get Extra Help with Your Prescription Costs

a photo of an open medicine bottle, with a prescription form underneathIn times like these, every dollar counts. Some people qualify for big savings on their Medicare prescription drug costs and don’t even realize it! In fact, if you receive Medicare, you may be eligible for the Extra Help, which could save you about $4,000 per year on your monthly premiums, annual deductibles, and prescription co-payments.

To qualify for Extra Help, you must be receiving Medicare, have limited resources and income, and reside in one of the 50 states or the District of Columbia. To find out if you qualify, Social Security will need to know the value of your savings, investments, real estate (other than your home), and your income. We will also need information about you and your spouse, if you are married and living together.

To apply for Extra Help, you need to complete Social Security’s Application for Extra Help with Medicare Prescription Drug Plan Costs. Our secure online application has self-help screens that guide you through a series of questions. You can apply from the comfort of your home, or from any other computer that is convenient to you. You can start and stop the application at any time, and go back later to finish it.

If you choose, you can apply for Extra Help over the phone by calling 1-800-772-1213 (TTY 1-800-325-0778) or visit your local Social Security office.

After you apply, Social Security will review your application and send you a letter letting you know if you qualify for Extra Help. Once you qualify, you can choose a Medicare prescription drug plan.

When you file your application for Extra Help, you can also start an application for a Medicare Savings Program — state programs that provide help to people with limited resources and income with Medicare expenses

Make sure you aren’t missing out on these easy savings. The sooner you apply , the sooner your savings begin.

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56 thoughts on “It’s Easy to Get Extra Help with Your Prescription Costs

  1. I have received this before and have told you that I do not qualify. My income is below the top limit, but my investments disqualify me. Please do not send this invitation to me again. My investments are not likely to be liquidated.

    • If you have investments, why do you think you’re entitled to help obviously created for people with extremely limited resources?

      Sounds like you’re a moocher

      • Moocher…are you kidding me? He and his employers have made contributions to Medicare during his working life. Are you expecting that you will only receive benefits if you are below the poverty line when it’s your turn to collect what you and your employers have paid into Medicare for YOUR benefit? Where does it say that your contributions will go to poor people, not people who make a good living and have saved money and invested for their retirement? You’re the moocher if your plan is to be lazy, work only in minimum wage jobs so that the rest of us can PAY your medical expenses when you retire. Give me a break!

      • It appears you are not understanding what Anne H. wrote. She is not applying, nor is she trying to get extra help, however, she has been receiving numerous invitations in the mail asking her to apply. She has repeatedly told SS she is not eligible, and has asked them to stop sending the invitation. She is only explaining why she wouldn’t be eligible for extra help. That’s far from being a “Moocher,” in fact, it’s probably more honest than most. You flunked your English Comprehension Course, correct?

        • I was not replying to Anne….I was replying to Michael. Anne didn’t use the term “moocher”, Michael did. You need to follow the threads to see which replies are in response to which comments. You are the one who should check your English comprehension, right?

    • Hi Betty, we are sorry to hear that you are having difficulty reaching someone by phone. We are experiencing higher than normal call volume. Representatives are available on Monday through Friday from 7 a.m. and 7 p.m. at 1-800-772-1213. Generally, you will have a shorter wait time if you call later during the week or later during the day. Members of the public who are deaf or hard of hearing should call the Agency’s toll-free TTY number at 1-800-325-0778. Remember, through our Blog and Facebook page, we respond to questions and provide general information on our Retirement, Survivors, Disability, Medicare and SSI programs. If you have a general question, we encourage you to ask here. But remember, never post personal information on social media. We hope this helps!

  2. Why don’t you just tell people what the income/asset requirements are instead of making people go through the whole application process to find out? What does limited resources actually mean in this instance?

    • You should complete this application for Extra Help on the Internet if: You have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance); and You live in one of the 50 States or the District of Columbia; and
      Your combined savings, investments, and real estate are not worth more than $27,250, if you are married and living with your spouse, or $13,640 if you are not currently married or not living with your spouse. (Do NOT count your home, vehicles, personal possessions, life insurance, burial plots, irrevocable burial contracts or back payments from Social Security or SSI.) If you have more than those amounts, you may not qualify for the extra help. However, you can still enroll in an approved Medicare prescription drug plan for coverage.
      EXCEPTION: Even if you meet these conditions, DO NOT complete this application if you have Medicare and Supplemental Security Income (SSI) or Medicare and Medicaid because you automatically will get the extra help.

        • John, if you do qualify, then you should apply. If you have made an unwise choice in a Part D Sponsor for 2016, and now you do qualify for the SSA Extra Help Program, then you can receive a Special Enrollment option to change Part D plans before the Fall AEP begins. Yes, that is possible if you do qualify for the SSA Extra Help Program.

          Another option available to you is to call your doctor and ask him to file for Exception to the Plan’s Formulary. The Plan will have to consider that request.

          In the future, you should review your drugs during the AEP, Annual Enrollment Period between Oct 15 through Dec 7 each year for Jan 1 effective date. If you can not find a local agent to help you, then you can call 1-800-Medicar, they will have representatives work with you over the phone.

    • to Retired, you may have a Deductible to meet (can be up to $360) during the Deductible Phase. Then during Initial Coverage Phase the Part D Plan will pay and your co-pay will be smaller. Look at the back of your AARP UHC card and call the member/policy holder phone number. They will explain to you. Or you can review your monthly Explanation of Benefits that comes in the mail to show prescription drugs you have filled during past month, it will review what you have paid, what ins co has paid, any balance remaining on your deductible. It will also likely track which phase you are in, and review your year to date totals.

  3. is this a scam? they use non-taxable VA compensations and pensions to disqualify you meanwhile they take medical and dental premiums and other costs from you that they count against you so you end up with less but they cover the illegals under Obamacare and welfare!

  4. I also have (AARP SCRIPT PLAN) & my Spouse has (Atena Script Plan) We pay more then $100.00 a Script. And my copay for Insulin is $750.00 a month, I was refused & so is My Husband. We live day to day..BUT WE WERE DENIED. So we go without “GOOD Food”.
    We pay out of our checks Med A & B &D
    What gives!

      • You pay them–while they are paying hundreds of millions of dollars to have several lobby groups in Washington to keep everything status quo. Nothing will change as long as they are the ones with the most clout against Congress!

    • Loretta
      These r real issues no one ever talks about I pay for insulin about 400 dollars amonth when I go in the donut hole which is a bunch of crap

  5. I am a Veteran and on disability pension from being a firefighter and collect SS which puts me out of range of being qualified even though my prescriptions and medical for a year are off the charts but can’t get any help. guess I should give up my citizenship and become an illegal.
    That way all medical would be covered

  6. I cannot figure out which bureaucracy this Extra Help come through. Is it from social security funds? Does it relate to state laws? I know people with Medicare plus Medicaid receive Extra Help. I just don’t know the funding streams and which agency regulates it.

    • Mildred,
      Social Security Administration Extra Help for Prescription Drugs. You can call 1-800-772-1213 Mon thru Fri. You can request that they connect you to someone to help you over the phone to apply. You need to have knowledge of your Gross Income, your current balance of cash accounts (cking, saving, CD’s, 401k, and extra Deeds – your home does not count as an asset resource however a 2nd Deed for other property will count as a resource).

  7. Hey! it seems so many different people look over teh applications that too many are denied or the extra help amounts to junk-change. i’m a retired veteran on only social security and i don’t have much in form of prescription bill but yet i was at the beginning getting 25-35% extra help, the n it was cut to 15% and now i have no idea for i pay 3 times as much for the one prescription i get thru Walmart and Humana and all but $200 of my income I save in each month for something extra may come up, as always does with premium increases, etc. I too eat very limited, some months crackers and peanut butter. my provider wants me to lose weight but my weight is now lost muscle tone. oh well us seniors are lower on the totem pole. no COLA for sometime and very little if any while everything goes up and COLA based on one commodity going down as gasoline but food went up. soon they announce a COLA premiums increase that January/February. its a lost cause!!!

  8. It is not extra help. I know a lot of people that lie on these things and get what they want. An honest person cant get it. they will get a divorce and tell them that they do not live there anymore but they do.

    • Hi Patricia, if you didn’t sign up for Medicare Part B when you were first eligible, and you aren’t eligible for a Special Enrollment Period, you can sign up during the General Enrollment Period between January 1–March 31 each year. To learn more about the Medicare enrollment periods visit http://www.Medicare.gov. For more information call us at 1-800-772-1213, M-F between 7a.m. and 7 p.m., and ask a representative to assist you, or contact your local office. Thanks!

    • Hi Mary, your eligibility will be reviewed every year to see if you still qualify for Extra Help. If you do qualify, you don’t need to reapply because the review will be sent to you automatically. However, if, in any year we tell you that you don’t qualify, but you think you do, you will have to re-apply. Remember, you can re-apply for Extra Help at any time if your income and resources change. If you have specific questions, please call our toll-free number at 1-800-772-1213. Representatives are available Monday through Friday, from 7 a.m. to 7 p.m. Thanks.

  9. I don’t qualify; but still pay through the nose for my meds! What people don’t know is that docs are getting paid on a percentage basis for the meds they prescribe…any “change” to an old med makes it new and therefore they can charge more until the patent expires again! I used to hit the donut hole about August, now I hit it this year in February!!! I pay over $500 a month for one of my pain meds because it’s now “new” as it is crush-proof so addicts can’t use it to get high. How did that become my faultl?

    • Doctors do not, as a rule, get paid for changing the medication. I am married to one and he does not get kick backs. You need to be up front in the discussion with your doctor about your meds and your financial situation. I don’t like paying a higher co-pay($50) for brand name when I could have gotten something that is a generic($10) in the same category that probably works just as well. I let my doctor know that I want generic and not the latest drug on the market. You have the right to your own health and your choices.

  10. I am very thankful for Social Security and Medicare. Many of us will live longer than our investment in the program. Many complaints about programs and benefits can be solved by READING the information provided by our government.

    Dont blame the government for for drug prices caused by business greed.

    • Thank you for sharing! Social Security is committed to providing world-class customer service today and in the years to come. We value your input!

  11. There are many ways to get help on Prescription Drugs.
    1. Call 800-772-1213 or go on-line to ssa.gov
    Ask for help with Social Security Administration Extra Help for Prescription Drugs.
    2. Call 800-Medicar and ask for the phone number of your local SHIP office, State Health Insurance Plan.
    3. Look in your local phone book for Community Based Services (many call it the welfare office, their name has changed over the years). Ask for an appointment and see if you qualify for QMB, SLMB, QI to help pay Part B Premiums, or qualify for Medicaid.
    4. Look in local phone book or ask your pharmacy/doctor office to please provide a phone number for your local Community Action Program. The CA offices partner with funding sources to help pay utility bills for those in need. They will also advise you of Nutritional Programs in your community that can provide boxes of food.

    There are programs in your community. If you can not find help then at least talk to any minister in your community, they will have knowledge of locations near you.

    For those who mentioned high costs for injectable like insulin or any other name brand drugs that are too costly for you, please ask your Provider, doctor or nurse or pharmacist to help you file for Patient Assistance on your medications.

    For our Veterans, thank you for your service. Please call the VA and see if you might qualify for medical care and prescription drug programs through the VA.

    I am not a federal nor state employee. I just know these services are available in every community.

    • Marti, this kind of help is only for people who have no home. Once you buy a house, no matter how cheap, you don’t qualify for any help. Might be better off to live on the street. I don’t think the government cares about the people who served their country and are now old. Not only military, just old people in general. It would take a LOT of convincing for
      me think otherwise.

  12. I am 65 years old and i was told to apply for medicare . My husband is an active employee and have a medical insurance for both of us but someone informed that I need to apply when i turned 65 anyway. Do I have to wait until my husband end up his job or do I need to apply now?

    • Hi Maria, If you are eligible for part A I would consider taking it as it is at no cost to you. As for Part B I would talk to HR at your husbands job to see if it is considered to be as good as Medicare. Because if it is then once your husband decides to retire then you and him if medicare eligible will have a special enrollment period to get part B and D .

    • Hi Maria. If you are 65 or older and not ready to start your monthly cash benefits yet, you can use our online retirement application to sign up for Medicare ONLY and apply for your retirement or spouses benefits later. If you already get Social Security benefits, we’ll automatically enroll you in Medicare Hospital Insurance (Part A) and Medical Insurance (Part B). However, because you must pay a premium for Part B coverage, you have the option of turning it down.
      Also, if your husband is actively working and you are covered under his employer’s group health insurance program, you can delay enrollment into Medicare Part B until your husband stops working or the health coverage is dropped. However, we suggest that individuals speak to their health benefits advisor, or health plan representative to see what’s best for them, and to prevent any penalties or delayed enrollment in the future. To learn more about the Medicare enrollment periods visit http://www.Medicare.gov. For specific questions about your case, call 1-800-772-1213, M-F between 7 a.m. and 7 p.m. and ask a representative to assist you, or you can contact your local office directly. Hope this helps!

  13. How is one suppose to make an intelligent choice about what Medicare D plan to enroll in when one month later there are new rates for the plans as it is a new year.

  14. I have turned in my application for yearly review for food stamps and medical extra help I have always qualified since Feb it had taken out 400.00 from my social security payment Jan and Feb then march April may all due to filling out forms faxed notified by confirmation so I never heard from state got notice food stamp approved and medical all re instated again still got my scripts paid.Copy 6 to 15.dollars still totally cheap. Help me understand again told medical denied again a nice lady beth finally just did application over phone I faxed bank statements that would start up my medical premium from being withdrawn from my social security check since January . ok finally I can ask i will get back all the huge premiums I paid. 6 months worth due to workers not using faxes I verified all requirements. I was told I won’t get all my premiums I paid . why can’t I please advice me asap

    • Hi John. Unfortunately and because of security reasons we do not have access to personal records in this blog and cannot answer your question at this time. One of our representatives should be able to provide you with an explanation and answer questions about your Extra-Help benefits and eligibility. Representatives are available Monday through Friday, between 7 a.m. and 7 p.m.

  15. I’m not going to qualify for Extra help..I worked my whole life and never had a copayment…I am not understanding how now that I am getting MUCH less $ I have to pay more for Medical.

    It seems everyone thinks Medicare is a good system.
    I don’t see it….I have to pay the 121 a month…then a Part D and then a supplement.

    As I fall just above the income requirements for help..about 200 dollars a year so divide that by 362 days or how many in a year…really?

  16. Why doesn’t “Extra Help” consider the applicant’s present prescription drug costs as a factor in determining eligibility for the program? Using only income and assets does not give much of a picture of the situation.
    In our situation the Part D premium, the deductible and the copays chew through a large percentage of our income but that’s not considered, as we struggle to keep up with 14 meds on a monthly basis.

      • I know “all” about the program because I’ve applied and been rejected because my income is a bit too high. My assets are minimal. My prescription coverage premium plus co-pays for 14 medications per month are astronomical but that fact is not considered in the application process, which is the point I was making. SO, even with much of my income going to prescription costs, I am out of luck. Nice, eh?

  17. I wish i was in a lot of y’alls shoes. I am on SSI disability Medicaid and only drawl $733 a month. I am only allowed 5 prescriptions a month. I am on 9 medications and I have to go some months and not take my medications cause I can’t afford The ones Medicaid TennCare refuse to cover. I have to pay $1276 out of pocket for 5 prescriptions that are not covered. I will never get Medicare cause when I applied for disability I was short on points. It took me 27 months to get ssi disability. While I was fighting for ssi disability I had CoverTN and I paid less for my meds than i do now. I can’t get extra help for Rx coverage. My family helps me as much as possible. I wish i could go back to work but I have a disease that causes me to lose my limbs. Yes Medicaid is good when it comes to paying in full on hospital stays and Dr.appointments but TennCare pays what they want too and I keep losing Doctors cause they quit taking my insurance. But Medicaid should have a program for extra help for medications. If i could purchase rx coverage it would be cheaper on me cause without one of my meds I have to not take cause it cost $662 out of pocket, keeps me in pain all day night long. .
    Please help Medicaid.

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