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What is the Extra Help Program? *ONLINE ONLY*

July 2024

By Medicare Rights Center

My pharmacist mentioned that I might be able to get onto a program called Extra Help. Can you explain the benefits of enrolling in this program?

-Malcolm (Houston, Tx)

Dear Malcolm,

Extra Help is a cost-assistance program that helps you pay for prescription drugs while on Medicare. It works by paying for your Part D premium (up to a state-specific benchmark amount) while lowering the cost of you prescription drugs.

Note: You pay no premium if you have a basic Part D drug plan with a premium at or below the Extra Help premium limit for your area. You will likely still owe a premium, though, if you have an enhanced Part D plan, even if the premium is below the benchmark.

Some extra perks are that if you qualify for Extra Help and happen to have a Part D late enrollment penalty, it will eliminate that fee. It also gives you Special Enrollment Periods throughout the year to enroll in a Part D or switch between plans.

You should automatically be enrolled in Extra Help if you have Medicaid, Supplemental Security Income, or a Medicare Savings Program. If that’s not the case for you, you might still be eligible if you have limited assets and your income is below $1,903 per month as an individual, or $2,575 as part of a couple.

Apply online through the Social Security Administration or contact the Medicare Rights Center for assistance applying.

I hope that helps!

-Marci

The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs and public policy initiatives.