Extra Help with Prescription Drugs

Some people with limited resources and income are eligible for Extra Help to pay for the costs—monthly premiums, annual deductibles, and prescription co–payments—related to a Medicare prescription drug plan. However, you must be enrolled in a Medicare Prescription Drug plan to get this extra help.

Who can get Extra Help?
To qualify for Extra Help:

• You must reside in one of the 50 states or the District of Columbia.
• Your resources must be limited to $12,640 for an individual or $25,260 for a married couple living together. Resources include such things as bank accounts, stocks, and bonds. Your house and car do not as resources; and
• Your annual income must be limited to $16,335 for an individual or $22,065 for a married couple living together. Even if your annual income is higher, you still may be able to get some help. Some examples where your income may be higher are if you or your spouse:
  • Support other family members who live with you;
  • Have earnings from work; or
  • Live in Alaska or Hawaii.

If you qualify for Medicaid, belong to a Medicare Savings Program, or get Supplemental Security Income (SSI) benefits, you automatically get Extra Help with Medicare drug costs. 

How to Apply for Extra Help

It is easy to apply for Extra Help. Just complete Social Security’s Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020). Here’s how:

• Apply online at Social Security;
• Apply over the phone or request an application by calling Social Security at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or
• Apply in person at your local Social Security office.

After you apply, Social Security will review your application and send you a letter to let you know if you qualify for the Extra Help. Once you qualify, you can choose a Medicare prescription drug plan. If you do not select a plan, the Centers for Medicare & Medicaid Services (CMS)  will do it for you. The sooner you join a plan the sooner you begin receiving benefits.

Click here for materials related to the CMS Best Available Evidence policy.