Medicare beneficiaries can qualify for Extra Help paying for their monthly premiums, annual deductibles, and co-payments related to Medicare prescription drug coverage.
We estimate the Extra Help is worth about $5,300 per year for each beneficiary. To qualify for Extra Help, you must be receiving Medicare and have limited resources and income. You must also reside in 1 of the 50 states or the District of Columbia.
Apply for Extra Help
The application for Extra Help does not enroll you in a Medicare Prescription Drug Plan. You do not need to be enrolled in a Medicare Prescription Drug Plan to file for Extra Help. However, the Extra Help assistance does not start until you’re enrolled with an approved Medicare prescription drug provider.
Other Ways to Apply
You can call us at 1-800-772-1213 (TTY 1-800-325-0778) to apply over the phone. You can also request a paper application, or you can schedule an appointment to apply at your local Social Security office.
For help completing your application, see Instructions for Completing the Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020-INST). The instructions are only guidelines and not to be used as applications.
These instructions are also available in other languages in our Multilanguage Gateway.
Appeal A Decision
If you disagree with the decision we made about your eligibility for Extra Help, you can complete an Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs. We also provide Instructions for Completing the Appeal.
Once You Receive Extra Help
If you are already receiving Extra Help, we must review your eligibility periodically. We’ll ask you to complete the Review of Your Eligibility for Extra Help (SSA-1026B) to ensure you’re still eligible for Extra Help and receiving all the benefits for which you are eligible.
Medicare Savings Programs (MSP)
With the Medicare Savings Programs, you can get help from your state to pay your Medicare premiums. In some cases, MSPs may also pay Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) deductibles, coinsurance, and copayments if you meet certain conditions. If you qualify for certain MSPs, you automatically qualify to get Extra Help paying for Medicare prescription drug coverage. To learn more, read Get help with your Medicare costs (CMS Product No. 10126).
- Understanding The Extra Help With Your Medicare Prescription Drug Plan (Publication No. 05-10508)
- Your Guide to Medicare Prescription Drug Coverage (CMS Product No. 11109)
- Quick Facts about Medicare Plans and Protecting Your Personal Information (CMS Product No. 11147)
- Other CMS Medicare Publications
- State Health Insurance Counseling and Assistance Program (SHIP)
- Extra Help program guide for organizations
- Medicare for Older Adults (National Council on Aging)
- Medicare Rx - Connect