Who gets Extra Help automatically?
You’ll get Extra Help automatically if you get:
Full Medicaid coverage
Help from your state paying your Part B premiums (from a Medicare Savings Program)
Supplemental Security Income (SSI) benefits from Social Security
You’ll get a letter about your Extra Help. It tells you things like how much you’ll pay, and your new Medicare drug plan, if you don’t have one already.
If you don’t automatically get Extra Help, you can apply for it:
Or call Social Security at 1-800-772-1213.
Who should apply for Extra Help?
In most cases, to qualify for Extra Help, you must have income and resources below a certain limit. These limits go up each year.
| Your situation: | Income limit: | Resource limit: |
| What counts in resource limits? | ||
| Individual | $20,385 | $15,510 |
| Married couple | $27,465 | $30,950 |
The income limit is based on your income from the previous year.
If you qualify for Extra Help
We’ll automatically enroll you in a
Medicare drug plan (Part D)
, if you don’t have one already. We do this so you can get the cost savings you qualify for.
| Extra Help Level: | In 2022, you’ll pay: |
| Full Extra Help | Plan premium: $0 |
| Plan deductible: $0 | |
| Prescriptions: | |
| Up to $3.95 for each generic drug ($4.15 in 2023) | |
| Up to $9.85 for each brand-name drug ($10.35 in 2023) | |
| Once your total drug costs (what both you and your plan pay) reach $7,050 ($7,400 in 2023), you’ll pay $0 for each covered drug. | |
| If you also get full Medicaid coverage and are in the Qualified Medicare Beneficiary (QMB) program, you’ll pay no more than $4.30 for each covered drug. Find out if you may qualify for QMB or other Medicare Savings Programs. | |
| Partial Extra Help | Plan premium: Varies based on your income. How much will I pay for my premium? |
| Plan deductible: No more than $99 ($104 in 2023) | |
| Prescriptions: No more than 15% of the cost for each covered drug | |
| Once the total drug costs (what both you and your plan pay) reach $7,050 ($7,400 in 2023), you’ll pay no more than: | |
| $3.95 for each generic drug ($4.15 in 2023) | |
| $9.85 for each brand-name drug ($10.35 in 2023) |
Even if you don’t qualify for Extra Help now, you can reapply for Extra Help any time if your income and resources change.
What Is This Application?
This is an application for Extra Help and does not enroll you in a Medicare prescription drug plan. You will have to enroll directly with an approved Medicare prescription drug provider for coverage. If you need information about Medicare Prescription Drug plans or how to enroll in a plan, call 1-800-MEDICARE (TTY 1-877-486-2048) or visit www.medicare.gov.
Who Should Complete This Application For Extra Help With Medicare Prescription Drug Plan Costs?
You should complete this application for Extra Help on the Internet if:
EXCEPTION: Even if you meet these conditions, DO NOT complete this application if you have Medicare and Supplemental Security Income (SSI) or Medicare and Medicaid because you automatically will get the extra help.
