Get Help Paying for Medicare Premiums, Deductibles, Copays

If you first apply for the federal Extra Help program for assistance with prescription drug costs, your application is automatically forwarded to your state to determine eligibility for a Medicare Savings Program.

Puerto Rico and the U.S. Virgin Islands don’t have Medicare Savings Programs, but their Medicaid programs may be able to assist you financially. See Medicaid.pr.gov in Puerto Rico and Medical Assistance Program in the U.S. Virgin Islands.

Extra Help pays for some Part D premiums, expenses

The federal government’s Extra Help program can pick up the tab for as much as $6,200 of your annual Medicare Part D premiums, deductibles and copayments.

You get it automatically if you have full Medicaid coverage, if you qualify for certain Medicare Savings Programs or if you’re receiving Supplemental Security Income benefits from Social Security. If you don’t get Extra Help automatically, you can apply for it.

If you apply for Extra Help, Social Security will send information to your state to start a Medicare Savings Program application. You can opt out on your Extra Help application.

2025 annual income and asset limits:

• Individual. $23,475 in income, an average of about $1,956 a month; less than $17,600 in assets.  
• Married couples. $31,725 in income, an average of about $2,643 a month; less than $35,130 in assets.  

In 2024, the program was simplified and income limits increased to 150 percent of the federal poverty level, a dollar amount that is adjusted annually for inflation and is higher in Alaska and Hawaii. If you’re also supporting family members who live with you, such as grandchildren, your annual income can be higher.

As with Medicare Savings Programs, if you’ve bought a cemetery plot and set aside up to $1,500 for funeral expenses, those won’t count against your assets.

If you qualify for Extra Help, you’ll need to enroll in a Part D prescription plan. If you don’t, Medicare will enroll you in one automatically. Check the Medicare Plan Finder to locate one that covers your medications.

6 steps to apply for Part D Extra Help

1. Gather the following documents:

• Bank statements.
• 401(k) or individual retirement account (IRA) balances.
• Statements for annuities, pensions, Railroad Retirement Board benefits or veterans’ benefits.
• Tax returns

Go to the Apply for Medicare Part D Extra Help program page at SocialSecurity.gov.

2. Click Apply online. You’ll see the Extra Help welcome page. Click Find Out If You Qualify for more information about eligibility criteria. When you’re ready to apply, choose the Previous button to return to the prior page and click Apply Now, where you’ll land on a Preparing To Use This Application page that looks similar to the Preparing To Find Out If You Qualify page.

3. Read the information. When you’re done, click Next.

4. Answer a series of personal questions. Click Next, potentially through a few pages.

5. Your answers to the previous questions are early steps in determining your eligibility for the program. If you qualify so far, you’ll be asked to apply. Click Apply Now.

6. Enter your name, Social Security number, date of birth and whether you worked this year and last year. You’ll be asked if your spouse is applying for Extra Help, too.

You’ll then be asked about your income and assets, which will help determine if you’re eligible for the program.  

If you need help completing the application, contact Social Security at 800-772-1213 or your State Health Insurance Assistance Program. The Social Security Administration has the online application in Spanish and provides instructions in several additional languages. You can review your completed application before you submit it.

Medicare will send you a notice in the mail about your Extra Help assistance. If you’re denied, you have 60 days to appeal by filling out Form SSA-1021, also available in Spanish.

Once you’re accepted for Extra Help, Medicare will enroll you in a Part D plan if you don’t have one or notify your current plan. If you fill a prescription and the credit isn’t applied, show the pharmacist your Medicare approval letter.

The government reviews your eligibility each year, and your participation in the program will continue automatically if you meet the qualifications. If you don’t, you’ll get a notice in the mail in September and can reapply.

Prescription payment plan spreads out what’s owed

While not financial help in the strictest sense, the Medicare Prescription Payment Plan, put into place in 2025 along with a $2,000 annual cap on out-of-pocket costs for drugs covered in your Part D plan or Medicare Advantage plan with prescription coverage, offers Medicare beneficiaries the option to spread medication costs throughout the year, instead of paying them all at once. So think of it as an interest-free budgeting tool.

You’ll still have to pay any monthly premium and medication costs up to the $2,000 limit for covered drugs.

If you find yourself with high prescription costs at the beginning of a year, enrolling in the program early could mean you’ll pay about $167 each of 12 months rather than $2,000 in one month. Enrolling later would stretch your outstanding bill over fewer months.

Medicare has a tool to determine whether the program is right for you. To enroll, contact your health or drug plan.

Explore state-run, private drug benefit programs

State prescription programs. If you don’t qualify for Extra Help or want to supplement its benefits, you may be eligible for a state pharmaceutical assistance program (SPAP) that can help with your prescription costs. Each program works differently, and some states have several to target specific needs.

To find out more, can call 800-MEDICARE or contact your State Health Insurance Assistance Program. Only Hawaii and Minnesota lack such plans.

State discount programs. At least 16 states — Arizona, California, Connecticut, Florida, Kentucky, Maine, Michigan, Montana, Nevada, New Jersey, New Mexico, Ohio, Oregon, Tennessee, Vermont and Washington — sponsor state prescription discount programs, sometimes in the form of cards or clubs.

The design of the programs varies among states, and not all cover residents 65 and older.

• Companies that negotiate drug prices between manufacturers and insurers and determine the payments that pharmacies receive, called pharmacy benefit managers, sometimes operate these programs for the states.
• Kentucky’s program points qualified residents toward manufacturers’ free and low-cost patient assistance programs.
• Washington and Oregon started a nonprofit, now called ArrayRx, that provides an electronic prescription discount card for residents. The program also serves Connecticut and Nevada residents.

Some state-sponsored programs may offer less expensive medicine than in your Part D plan.

But be aware: These programs are not the prescription insurance equivalent of a Part D plan, don’t generally add discounts on top of your insurance price and won’t count toward the $2,000 limit in annual out-of-pocket costs for covered drugs that has been in place since Jan. 1, 2025. That limit adjusts annually for inflation and will be $2,100 in 2026.

Patient assistance programs. Pharmaceutical companies run these programs to help you get drugs or medical care at a low cost. Each manufacturer makes its own rules, but some have income limits or restrict Medicare recipients from participating.

These programs are independent of Part D plans, so any payments required won’t count toward your $2,000 annual limit. RxAssist offers a free database of participating companies, searchable by medication or company name.

Prescription discount cards. Companies such as Blink Health, GoodRx, Optum Rx, Single Care and WellRx have relationships with multiple pharmacy benefit managers to offer discounts on brand and generic medications.

Many have moved away from paper discount cards, instead allowing consumers access to their online databases to compare medication prices at nearby drugstores. But some still offer printed cards to show at participating pharmacies.

If you think you’ll have to pay the uninsured, cash price for a medication because your Part D plan won’t cover it, these programs are worth checking out. They also are not Part D insurance equivalents, and using them will not count toward the $2,000 out-of-pocket cap.

This story, originally published Jan. 28, 2022, is updated annually with new eligibility numbers and other changes.