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“Extra Help” is just that. Are you eligible to save on drug costs?

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If you are currently enrolled in or planning to sign up for Medicare, the Extra Help program can assist you in paying your prescription drug costs. Maybe you struggle to afford your Medicare Part D plan or wonder if your income qualifies you for additional aid. Many people who qualify for Extra Help don’t even realize that they do! Regardless of your circumstances, we’ve outlined the basics of Extra Help and how you can check your eligibility.

What is Extra Help?  

Extra Help is a government program designed to help individuals—specifically those with low income or limited resources—pay for Medicare Part D. It can cover premiums, deductibles, and copayments associated with your prescription drug plan. Coverage varies, but the Social Security Administration estimates that it’s worth about $5,300 in savings each year.

You must meet the federal government’s financial criteria to qualify for Extra Help coverage. Limits on your annual income and available resources determine if you are eligible.

How can I qualify for Extra Help?

There are two ways to qualify for Extra Help. You may be automatically enrolled if you receive:

  • Full Medicaid coverage
  • Help from your state paying your Part B premiums through a Medicare Savings Program
  • Supplemental Security Income benefits from Social Security

You could also qualify for Extra Help based on your level of income and resources, so if you aren’t automatically enrolled in the program, you can apply for it. Many people are eligible for savings through Extra Help and don’t know it, so it’s a good idea to apply.

Depending on whether you're single or married, income and resource limits differ. Below are the 2024 Extra Help eligibility requirements.

Requirements for Individuals

  • Single, divorced, or living separately
  • Enrolled in Medicare Part A and/or Medicare Part B 
  • Annual income of $21,870 or less
  • Resources valued at $17,010 or less

Requirements for Couples

  • Married and living with your spouse
  • Enrolled in Medicare Part A and/or Medicare Part B 
  • Annual income of $29,580 or less
  • Resources valued at $33,950 or less

Based on the specifics of your situation, you may still be eligible for Extra Help if your income is above the annual limit, so you are still encouraged to apply.

It’s important to note that when the government looks at your resources, it considers the value of the things you own, such as money you have in a checking or savings account, bonds, and stocks. It does not factor in assets like vehicles, your home, furniture, or household items.

How to Enroll 

In many cases, individuals are automatically enrolled in Extra Help. You may also be enrolled automatically if you receive other assistance, such as Medicaid.

If you’re not automatically enrolled in Extra Help, you can apply for it online or call Social Security at 800.772.1213 to request an application or enroll over the phone. Alternatively, you may apply in person at your local Social Security office.

Even if you aren’t sure how much coverage you may qualify for, you’re encouraged to apply. Applying for Extra Help costs you nothing and does not affect your current health coverage or access to other benefits.

If your resource or income levels change at any point, you can recheck your eligibility and enroll in additional aid as needed. 

We’re here to help!

If you’re a RetireMed client and have questions about Extra Help or Medicare Part D, our team is ready to help. Contact our client advisors at 877.222.1942 or schedule a call.

If you’re new to RetireMed and would like to learn more about Medicare or how we can assist you, reach out to our advisors at 866.529.1181 or schedule a call.