Medicare, Online Services

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

April 21, 2016 • By

Reading Time: 2 Minutes

Last Updated: August 19, 2021

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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About the Author

Jim Borland, Assistant Deputy Commissioner, Communications

Jim Borland, Assistant Deputy Commissioner, Communications

Comments

  1. janet F.

    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.

  2. STEVE J.

    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!!!

    • Heidi

      I think the government does not care 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.

  3. Mildred

    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.

    • Marti

      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).

    • Heidi

      I am pretty sure medicare is federel and medicade is state.

  4. Robert W.

    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

    • Janet B.

      Check out GoodRX and Needy Meds online for help!
      Good Rx is FREE, Great Savings and shows pharmacy prices can Vary as much as $100. You need a printer or show on your phone, these are “coupons”.
      Needy Meds lists Drugs that have Assistance programs either thru manufacturer or other. Qualifications Vary. Also lets you know if Any Other Help out there that applies to each drug!!
      GOODRX and NEEDYMEDS CHECK THEM OUT!!
      Note: Good Rx can be used even if you have Medicare or Insurance. Go online, check the price GoodRx can get you, Then Compare cost. If GoodRx is Cheaper, then go to pharmacy and say: I want to use This Coupon for my prescription, Not my …… either your insurance or Medicare. You can’t use Both, it is Either, Or.

  5. kathy k.

    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!

    • kathy k.

      We ALSO Pay out Of Our Check For AARP, Atena, Dental, Eyeglass, & one more insurance!

      • Susan

        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

      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

    • Charlotte C.

      You really need help. You are in the wrong place in my opinion. I wish I had your telephone number. I know I could help you.

  6. rob

    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!

    • Charlotte C.

      Do you work with an Agent, Advocate? Find you a good one and ask for their help so that they can address that complaint. You don’t get that service if you make a direct call. Somebody that really cares about their job in placing beneficiaries in the RIGHT plan can make a difference in your life.

  7. Retired

    I have insurance ( AARPUnitedHealthcare ) and I end up paying more than their share, so what is going on?

    • Marti

      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.

  8. jstearns

    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?

    • johnh

      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 C.

        What good is the program if my Part D insurer doesn’t have my prescriptions in their formulary?

        • Marti

          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.

    • Ray F.

      Please see “Extra Help With Medicare Prescription Drug Plan Costs” for complete information.

    • Charlotte C.

      Because they vary. There are limits, but at the same time if you are raising grandchildren or a handicapped child, it does make a difference. By the way Social Security & Medicare are not entitlements. We earned those benefits and we have many Seniors that still suffer and try to live on SSI which is UP TO $740.00 a month. Try living on that. I have worked and met with a lot of people that were in that situation through no fault of their own.

  9. Betty C.

    I have been trying to talked to some one with s.s. for two weeks so far have not. Any suggestion.

    • Ray F.

      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!

  10. Anne H.

    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.

    • Michael

      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

      • Susan

        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!

        • Melody

          Well said, Susan! I agree with you 100%! I could go on and on supporting that.

        • jacki

          your not black—

        • Claudine M.

          I agree totally with you!

      • cjashley

        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?

        • Marcia J.

          Well said. Both in defense of the alleged “moocher” and a touch of reality to the name caller.

          • Randy B.

            I worked my but off for 35 years.&make $12,329 a year. So I don’t think that makes me a moocher. I don’t own a home land, buried plots, nothing. My wife can’t work because she has to take care of me.I worked very hard for Benefits. R.Barger

        • susan

          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?

        • Charlotte C.

          You got that one right. They really mis-understood her. She is willing to stick with her small income and keep her investment for either sentimental value or maybe to use in a tougher situation. Congratulations on being observant.

      • EJ

        That’s not what she said, read it again.

Comments are closed.