Overview
Extra Help with Medicare is a federal program that helps lower income individuals pay for prescription drug costs like premiums, deductibles, and copays for drugs. To qualify for this program the individual must meet certain income limits that are adjusted each year. Below we will discuss the qualifications for apply for extra help, as well as the limits mentioned.
Qualifications
1. You must be a U.S. citizen or legal resident for a minimum of five years.
2. Enrolled in Medicare Part A and or B.
3. Meet Income and asset limit requirements.
Extra Help Limitations
These limits are based on the individual's adjusted gross tax return figures. Government assistance like housing assistance or food stamps do not negatively affect limitations.
Assets Counting Toward Limitations
- Checking/Savings account money
- Real estate outside of primary residence
- Stocks, bonds, mutual funds, cash and retirement accounts
Assets That Do Not Count
- Primary residence
- Vehicles
- Burial savings
- Personal belongings
Circumstances That Allow for Higher Income with Extra Help
- Providing financial support for family members the individual lives with
- Earned money while working
- Living in Hawaii or Alaska
Drug Copays with Extra Help
In 2024, those who receive full extra help benefits will pay $4.50 for generic drugs and up to $11.20 for brand name drugs. If the total for drugs throughout the year reaches $8,000 paid into by both beneficiary and carrier, covered drug copays will be $0 for the rest of the year.
Applying for Extra Help
- Apply online at www.ssa.gov/medicare/part-d-extra-help
- Calling Social Security at 1-800-772-1213
- Visiting your local Social Security office
