Saving Money With Medicare’s Extra Help Prescription Program

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.

Medicare Extra Help 2024 Expansion

Folks on Medicare will get more assistance affording their prescription drugs in 2024. That’s because as of January 1, Medicare made changes to the Extra Help program that expand its coverage.

• Previously, the Extra Help program had two levels: full benefits and partial benefits. Full benefits were only available to people with income up to 135% of the federal poverty line. Partial benefits were available for those up to 150%.
• Now in 2024, partial benefits are eliminated, and full benefits are expanded to most individuals with incomes up to 150% of the federal poverty line—$21,870 annual income for an individual or $29,580 for a married couple.
• In addition to the annual income limit, to qualify for Extra Help an individual must have resources of less than $16,600 ($33,240 for a married couple). Please note that income and resource limits are different in Alaska and Hawaii. Check out Medicare.gov for more information. 

This expansion helps 300,000 people who were already enrolled with partial benefits get more financial assistance. In 2024, everyone who qualifies for Extra Help will pay:

• $0 for their Medicare drug plan premiums
• $0 for their plan deductibles
• A reduced amount for both generic and brand-name drugs

Extra Help estimates an average value of $5,300 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.

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.
• Shop around for Medicare Part D drug plans that offer additional coverage during the Medicare drug coverage gap.
• 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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