Medicare Extra Help

What is Medicare Extra Help?

Are you struggling to pay for prescriptions or medical costs? Individuals with limited resources may qualify for a federal benefit known as Medicare Extra Help. This program offers multiple benefits to its members:

• lowers the cost of your prescription drugs
• eliminates any Part D late enrollment penalty
• and pays up to a benchmark amount toward your prescription drug plan premium

You could qualify for full or partial assistance, depending on your income and assets. In order for you to receive assistance, your prescriptions must be on your plan’s formulary. Medicare Extra Help is not a replacement for Part D or a plan in itself, it works to supplement your Part D plan.

Find Out if You Qualify

If you are enrolled in Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program (MSP), you automatically qualify for Extra Help, regardless of whether you meet Extra Helps’ eligibility requirements.

You may qualify for Medicare Extra Help if:

• Your annual income is less than $21,870 as an individual or $29,580 for couples in 2023, AND

• Your resources are below a specific threshold of $16,600 for an individual and $33,240 for couples in 2023. Here are how the value of the various resources are either counted or not-counted towards these limits:

Countable Resources:

• Money in checking & savings accounts
• Stocks
• Bonds

Non-countable resources (source):

• Your home
• Personal belongings
• One car
• Burial Plot
• Furniture

How Do I Apply for Medicare Extra Help?

To apply for Medicare Extra Help, fill out Form SSA-1020 online. You can also call Social Security to apply over the phone or visit your local Social Security office to apply in person. Social Security will mail a letter to you, informing you of whether you qualify for Extra Help. You can choose a Part D prescription drug plan after you qualify for Extra Help. The Extra Help benefit is estimated to be worth about $5,300 per year— this is massive savings!