Medicare Extra Help

How to Apply for Medicare Extra Help to Cover Your Medicare Part D Prescription Drug Coverage Costs

If you have Medicare and are having trouble paying for your Medicare drug plan out-of-pocket costs, you may be able to get help through a program called “Extra Help.”

Extra Help is a program run by the Social Security Administration that can help pay for some of your Medicare costs, including premiums, deductibles, and coinsurance.

To see if you qualify for Extra Help, you must complete an extra help application. This article will walk you through applying for Medicare’s Extra Help assistance program.

What is the Extra Help Medicare Program?

The Extra Help Medicare Program is for people with Medicare Prescription Drug (Part D) coverage but has limited income and resources to afford Medicare Part D plan costs.

People who qualify for the Extra Help program will pay less towards their Medicare prescription drug costs. Medicare’s extra help program can reduce monthly premiums, copayments, deductibles, and max out-of-pocket prescription drug costs.

Medicare Part D Extra Help is also available to cover the costs of the Part D coverage gap.

What does the Extra Help Program Cover?

The Extra Help program covers things like their Medicare RX monthly premiums and copayments for prescription drugs for people with Medicare who have limited income and resources. 

People with Extra Help will not have to pay a Part D late enrollment penalty.

What are the Benefits of the Extra Help Program with Medicare?

What are the Benefits of the Extra Help Program with Medicare?

1. Extra Help Program: Helps with Medicare Costs to reduce your out-of-pocket Prescription Drug costs

The Extra Help program provides financial assistance to low-income Medicare recipients to help cover their monthly prescription drug costs. The program can reduce out-of-pocket costs by a significant amount, especially for those with multiple prescriptions.

There are two levels of coverage under the Extra Help program: Full and Reduced Extra Help. Full Extra Help provides the most financial assistance, while Reduced Extra Help still provides some financial assistance.

2. Extra Help Program: Help with Medicare Costs by lowering your medication copays and deductibles

The Extra Help initiative is an initiative supported by the government, which aims to aid Medicare beneficiaries who have inadequate income and resources to cover some or all of their prescription drug program expenses. This includes lowering your medication copayments and deductibles.

3. Extra Help Program: Helps save Medicare Beneficiaries money on other healthcare services

The Extra Help program can save qualified individuals $5,000 or more each year. You may qualify for these savings if you have Medicare and Part D coverage but have limited income and resources.

Social Security will send information and help you find out if you qualify based on current Medicare extra help income limits.

4. Extra Help Program: Help you save on Medicare Prescription Drug Coverage insurance premiums

The Extra Help program can help Medicare beneficiaries save money on their monthly premiums, yearly deductible, prescription co-payments, and coinsurance. The program is open to anyone with Medicare and Part D coverage.

5. Extra Help Program: Can eliminate your Medicare Part D late enrollment penalty

Extra Help is a Medicare program to help people with limited income pay for Medicare Part D costs. Those who qualify will not have to pay a Part D late enrollment penalty.

If you need extra help to pay your Medicare Part D costs, you need to reach out to the Social Security Administration and inquire directly with the government.

Unfortunately, Medicare insurance agents are not allowed to provide assistance at this time.

Who is Eligible for the Extra Help Program to Cover Medicare Costs?

1. Individuals with an income of less than $20,385 in 2022

Individuals are eligible for the Extra Help Program to Cover Medicare Costs if their income is between $20,385 for the year 2022. Married couples are eligible for the Extra Help Program to Cover Medicare Costs at a higher income limit based which can increase based on the number of children they have.

2. Individuals who are 65 years of age or older

Individuals who are 65 years of age or older are eligible for the Extra Help program because they may have difficulty paying for their Medicare costs.

3. Individuals with a disability

If you qualify for Medicare as a result of a disability, you may be eligible for the Extra Help Program. You must meet general requirements such as residing in a state or the District of Columbia, receiving Social Security Disability benefits, and having an income and resources below certain thresholds.

4. Individuals who are Medicare beneficiaries

The Extra Help Program provides subsidies to help pay for part of your monthly Medicare Part D premiums. To be eligible for the Extra Help Program, you must be a Qualified Medicare Beneficiary, a Specified Low-Income Medicare Beneficiary, or a Qualifying Individual.

5. Individuals who qualify for a standalone Medicare Prescription Drug Plan (PDP)

Individuals enrolled in a standalone PDP plan can qualify for the extra help program if they meet specific income and resource requirements.

6. Individuals who are enrolled in a Medicare Advantage Plan (MAPD)

Medicare Beneficiaries enrolled in an MAPD plan that includes Pat D coverage may be eligible for the extra help government program.

How Do I Automatically Get Approved for the Extra Help Program?

How Do I Automatically Get Approved for the Extra Help Program?

Some individuals automatically qualify for Extra Help if they are enrolled in Medicare and also qualify for the following:

  • Already qualify and receive full Medicaid coverage benefits.
  • Medicare beneficiaries enrolled in a Medicare Savings Program, that pays their Medicare Part B insurance premium.
  • Receiving Supplemental Security Income benefits.

You may not qualify next year for Extra Help if your income or resources change, or the Extra Help program adjusts its eligibility limits. You’ll receive a notice in the mail on from the Social Security Administration by the end of September if this is the case.

How do you apply for Extra Help with Medicare Costs?

Step 1: Check if you’re eligible

To be eligible for Extra Help with Medicare Costs, an individual must have an annual income below the current year’s maximum allowable amount. Additionally, the individual must be a U.S. citizen or a legal permanent resident and be enrolled in a Medicare Part D prescription drug plan.

The amount of extra help will be based on your overall financial situation.

Step 2: Gather your information

Medicare beneficiaries must gather the following information and provide it to the government.

  1. Provide their assets and income.
  2. Choose a drug plan provider.
  3. Gather your Social Security number and date of birth
  4. Proof of Eligibility for Medicare
  5. Proof of enrollment in Medicare Part A and Part B
  6. Complete the application and apply for Extra Help with Medicare Costs.

The Social Security Administration will review their application and send them a letter to let them know if they qualify.

Step 3: Apply online or by mail

Medicare beneficiaries can apply for Extra Help by completing an online application. The link to the online application is available on the Social Security website. You can also call 1-800-772-1213 to speak to a representative.

Step 4: Renew your Extra Help

It is essential to renew your Extra Help to ensure your Medicare Costs will continue to be covered.

What Qualifies as Income and Financial Resources According to the Extra Help Program Guidelines?

To qualify for Extra Help, applicants’ income and financial resources must be below the poverty line. The government will take into consideration the following items:

  • Bank accounts (checking and savings accounts)
  • Certificates of Deposits (CDs)
  • Stock, 401K, IRA, and mutual funds
  • US Saving Bond
  • Real estate properties such as investment properties or second homes
  • The cash you have on hand.
How much can the Medicare Extra Help Program save you on Part D Costs?

What is Excluded from the Extra Help Program Resources List?

The “Extra Help” program does not count the following resources related to meeting eligibility requirements:

  • Your Primary home
  • Your vehicle(s)
  • Burial plot and up to a specified burial costs limit for monies set aside and identified for this purpose
  • Personal or household items
  • Jewelry
  • Life insurance policies

How much can the Medicare Extra Help Program save you on Part D Costs?

The Medicare Extra Help Program can save recipients up to $5,100 or more each year on Part D costs. The level of Extra Help a beneficiary receives on their income.

How Do I Apply for Original Medicare?

You can apply for Original Medicare by going online, by phone, or in person at your local SSA office.

How Do I Apply for Medicare Part D Prescription Drug Plan?

Call and talk to one of our independent Medicare Agents and discuss your Part D needs. We will need a list of your current medications, dosage, and how often you take your medications per day.

As an independent Medicare Agency will shop all available insurance companies to find a company and plan that is best for you.

How Do I Apply for a Medicare Supplement Plan?

You can apply for a Medicare Supplement Plan by talking with one of our Medigap insurance agents. They will discuss all plan options and discuss which Medicare Supplemental plan many older adults choose.

You are required to be enrolled in both Medicare Part A & B before you can enroll in a Medigap Plan.

How Do I Apply For a Medicare Advantage Plan?

To sign up for a Medicare Advantage Plan, the person must first be eligible and enrolled in Medicare Part A and Part B.

There are many different types of Medicare Advantage plans, and one of our Medicare Advantage agents will go over each plan to ensure you sign up for the best one.


What are the eligibility requirements for Extra Help?

The eligibility requirement changes each year based on the current poverty level guidelines. Please review the guidelines identified by the government for more information.

How do I apply for the Medicare Extra Help Program?

To apply for the program, you must complete an application and send it to the Social Security Administration. The application can be found on the Social Security Administration’s website. You can also call and apply over the phone at 1-800-772-1213 (TTY 1-800-325-0778), which may be the fastest option.

How long does it take to get approved for Extra Help with Medicare Costs?

Getting approved for Extra Help with Medicare Costs can take up to two months. If you qualify, you must apply for Extra Help through the Social Security Administration.

What happens if my circumstances change and I no longer qualify for Extra Help with Medicare Costs?

If an individual no longer qualifies for the Extra Help program with Medicare, you will be responsible for the full costs of your Part D plan.

I think I may be eligible for Extra Help with Medicare Costs. Where can I get more information?

If you have Medicare and receive Medicaid, PACE, or SSI benefits, you may be eligible for “Extra Help” with your Medicare costs. To apply for Extra Help, you can fill out an application through the Social Security Administration (SSA) website or at your local Medicaid office.

You may also need to complete an online application and call Social Security to qualify for Extra Help.

Does the Extra Help Program pay my Medicare Part B premiums?

The Extra Help Program does not pay for your Medicare Part B premiums. Extra help will pay for Medicare prescription drug premiums, deductibles, and copayments.

Medicare beneficiaries must apply through the government to get help paying for their Medicare drug coverage.

Is the Low-Income Subsidy (LIS) the same as the Extra Help Program?

Yes, The Low-Income Subsidy (LIS) and the Extra Help Program and the same program offered by the government. Individuals must be eligible for Medicare before they can apply for LIS.

Am I required to re-apply for Extra Help annually?

Individuals are not required to re-apply for Extra Help annually. The government will examine your income annually based on your tax returns.

Get Extra Help Enrolling In A Medicare Advantage Plan

Integrity Now Insurance Brokers wants to help find a Medicare Advantage plan that provides excellent health benefits and is cost-effective. While the extra help you receive can help you pay a monthly premium for Medicare Part B or Part D, we are helping to help you find a zero-premium Medicare Advantage plan in your zip code.

Even if you receive partial extra help, we have access to some of the best Medicare plans, which can help keep your cost low. Our Medicare Advantage agents are licensed and certified in Medicare.  

You have come to the right place if you are looking for a local California Medicare Agent or Arizona Medicare Agent. No matter where you are located in the US, we are your single source for information and help to enroll in a Medicare plan.

Call us today to receive extra help from our experienced Medigap Agents.