Medicare Extra Help Program

Extra Help is a prescription drug savings program for Medicare beneficiaries with limited income and resources.

This program, also known as the Part D Low Income Subsidy, is administered by the Social Security Administration and the U.S. Centers for Medicare & Medicaid Services.

The amount you can save on your Medicare costs depends on your income and resources.

You can receive either a full subsidy or a partial subsidy.

You must have both limited income and limited resources to qualify for the Extra Help program.

In 2022, your annual income can’t exceed $15,510 for an individual or $30,950 for a married couple living together. This includes Social Security and pension payments.

However, not all cash payments count as income. For example, money from the Supplemental Nutrition Assistance Program (food stamps), earned income tax credit payments and educational grants don’t count toward the limit.

Other forms of assistance — including housing assistance, home energy assistance, disaster relief and assistance from others who help you pay your household bills — also don’t count as income.

To qualify for Extra Help, your resources can’t exceed $15,510 for an individual or $30,950 for a married couple living together.

Several resources don’t count toward the Extra Help limit, and therefore won’t impact your eligibility.

Keep in mind that you may no longer qualify for Extra Help if your income and resources change in the future.

Depending on your income and resources, you may qualify for either partial or full Extra Help benefits.

If you’re dual-eligible for both Medicare and Medicaid or you’re enrolled in a Medicare Savings Program, you automatically qualify for full Extra Help benefits.

You’ll qualify for $0 prescription drug premiums. Copays at the pharmacy for Medicaid recipients range between $1.35 and $4 per prescription while copays for Medicare Savings Program enrollees range between $3.95 and $9.85 per prescription.

Some people automatically qualify for Extra Help. In these situations, you do not need to apply for the program.

Medicare will mail you a letter on yellow paper if you automatically qualify for Extra Help. Keep this for your records.

If you’re not enrolled in one of the programs above, you must apply to the Social Security Administration to receive Extra Help.

After you apply, Social Security will review your application before mailing you a letter to let you know if you qualify. You’ll receive a letter printed on green paper if you qualify.

After you qualify, you can pick your Medicare Part D drug plan. If you don’t select a plan, Medicare will automatically enroll you in one.

When you file your application for Extra Help, you can also apply for the Medicare Savings Programs. Social Security will send information to your state, and your state will then contact you and help you apply.

Medicare Savings Programs are joint federal and state programs that help people with limited resources and income pay other Medicare costs, including your Part A and Part B premiums and, potentially, your deductibles and copayments as well.