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Help Paying For Drugs -- The Extra Help Program

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Medicare "Extra Help" provides help paying for the costs of Medicare Part D for people with limited income and assets.

Extra Help is easy to apply for. You can apply for Extra Help at any time

Eligibility lasts for a full year. For example, if you request Extra Help in February of one year, it lasts until February of the next year.

Elibgibility requires that you have limited income and assets. The dollar amounts vary from year to year.   

  • If you have a Medicare Savings Program (QI-1, SLMB, or QMB), or receive Supplemental Security Income (SSI), you automatically qualify for Extra Help.
  • Assets include bank accounts, investments, cash value in life insurance policies and real estate other than your home. Cars, funeral expenses up to $1,500, personal property are also excluded.
  • To learn current income and asset requirements, call 800-MEDICARE (800.633.4227)
  • Before you apply for Extra Help, do the math. If your income is low enough to qualify for a drug companies' patient-assistance program but not low enough to qualify for the full Extra Help subsidy, you may be better off skipping Part D and getting free prescription medications from the manufacturers.

If you qualify and:

  • Are already enrolled in a Part D Plan: Medicare will notify the Plan. The Plan will reduce your costs appropriately. You don't have to do it.
  • Not yet enrolled in a Drug Plan, you can enroll when you qualify, even though it is outside a normal period. If you don't enroll after asking for Extra Help, you will automatically be enrolled in a Plan.

With Extra Help, you can change Drug Plans once a month. While this is your right, it is not necessarily a good thing to do. Constant changes increases chances something will go wrong with coverage.

If You Receive Medicaid Or Supplemental Security Income, Or If Your State Pays Your Medicare Premiums

  • You automaticdally qualify for Extra Help.
  • You pay no premium or deductible.
  • Your copays for each prescription are limited to $1 or $2 for generics and $3 or $5 for brand drugs
  • You pay nothing for drugs in the catastrophic area

If You Are In A Nursing Home

Drugs may be covered as part of the nursing home costs. If that is the case, you may pay nothing for drugs.

For information about how to apply for Extra Help, click here

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