Medicare Part D is prescription drug coverage for people on Medicare. Part D plans are sold by private companies and often include out-of-pocket costs such as premiums, deductibles, coinsurance and other costs. Many people with limited income and resources can get assistance covering these costs through the Medicare “Extra Help” program.
Some people qualify for the Extra Help program automatically, including people who have full Medicaid coverage, people who get help from their state paying their Part B premiums, and people who get Supplemental Security Income (SSI) benefits from Social Security. People who have limited income and resources—but don’t automatically qualify for Extra Help—must apply.
Qualifying for Medicare Extra Help in 2025
In order to qualify for Extra Help in 2025, you must fall within certain income and resource limits. Resource limits include money in a checking, savings or retirement account; stocks; and bonds.
- Individuals must have income below $23,475 and a resource limit below $17,600.
- Married couples must have income below $31,725 and a resource limit below $35,130.
- Income and resource limits are different in Alaska and Hawaii. Check out Medicare.gov for more information.
In 2025, everyone who qualifies for Extra Help will pay:
- $0 for their Medicare drug plan premiums.
- $0 for their plan deductibles.
- Up to $4.90 for each generic drug and up to $12.15 for each brand-name drug. Once your total drug costs reach $2,000, you’ll pay $0 for each covered drug.
Extra Help estimates an average value of $6,200 per year for participants—yet there are up to 3 million seniors and people with disabilities who could benefit from the Extra Help program but aren’t currently enrolled.
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How to Apply for Medicare Extra Help
If you already received any level of Extra Help and still meet qualifications, you don’t need to reapply. The additional cost savings will be automatically applied!
Do you think you might qualify for the Extra Help program? Be sure to check out this helpful online brochure from the SSA, which explains how the program works and gives more details about income and resource limits.
If you’re ready to apply, you can do so online or by calling Social Security at 1 (800) 772-1213. TTY users can call 1 (800) 325-0778. You can also contact your local State Health Insurance Assistance Program (SHIP) to receive free help applying.
What if I Don’t Qualify for Medicare Extra Help?
It can be frustrating to feel like you can’t afford your prescriptions—but also not qualify for help. However, there are a few strategies that can help you save money on prescription drugs:
- Talk to your doctor to see if there are generic or less-expensive name-brand drugs that you could take.
- See if you could lower your prescription costs by using a mail-order pharmacy.
- See if there’s a Pharmaceutical Assistance Program that can help lower the prescription costs for your drugs.
- See if your state has a State Pharmaceutical Assistance Program.
Want more? Check out our blog, AEP, IEP, ICEP, GEP, OEP, SEP…Medicare Enrollment Periods Explained.
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