Get Help Paying for Medicare Premiums, Deductibles, Copays

The Qualified Disabled & Working Individual Program is for people with disabilities who have returned to work, lose Social Security disability benefits and don’t qualify for premium-free Part A of because they’re working again. It also helps pay for Part A premiums.  

2024 monthly income and asset limits:

• Individual — $5,105 in income, less than $4,000 in assets.  

• Married couples — $6,899 in income, less than $6,000 in assets.  

Learn more about Medicare Savings Program income and asset calculations and financial eligibility guidelines. Other good sources for information and eligibility requirements are your state Medicaid program and your State Health Insurance Assistance Program (SHIP). Application requirements vary by state.

If you apply for Extra Help 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 to make Part D more affordable

For assistance paying premiums, deductibles and copayments for Part D prescription drug plans, Extra Help can reduce your out-of-pocket expenses.

You can 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. To qualify in 2024, your assets must be worth $17,220 or less for individuals or $34,360 or less for married couples living together. This includes an allowance of up to $1,500 per person for burial expenses.

Your income in 2024 must be less than $22,590 for an individual or $30,660 for married couples living together. The income limits, which change annually, are based on the federal poverty level and are higher for Alaska and Hawaii.

For more information, see the Social Security Administration’s Understanding the Extra Help With Your Medicare Prescription Drug Plan and Medicare’s Extra Help page.

If you qualify for Extra Help, you’ll also 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 find one that covers your medications.

6 steps to apply for Part D Extra Help

1. Gather the following documents:

• Bank statements and tax returns.

• IRA or 401(k) account balances.

• Statements for annuities, pensions, Railroad Retirement Board benefits or veterans’ benefits.

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, click Apply Now.

3. Read the information on the next screen that explains how to complete the online application. When you’re done, click Next.

4. Answer the series of personal questions. Click Next.

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 provides instructions in several languages for filling out the application. You can review your completed application before you submit it.

Medicare will send you a notice identifying your level of Extra Help assistance. You may get full or partial assistance depending on your income and assets and whether you have Medicaid coverage or receive aid from a Medicare Savings Program.

Once you’ve enrolled in Extra Help, Medicare will notify your Part D plan. If you fill a prescription and the credit isn’t applied, show the pharmacist the Medicare approval letter.

More people qualify in 2024

The income limits to qualify for full Extra Help increased in 2024, thanks to the Inflation Reduction Act. In the past, people who earned from 135 percent to 150 percent of the federal poverty level were eligibile for partial Extra Help with a lower level of assistance. In 2024, the income threshold for full Extra Help increased to 150 percent of the federal poverty level and partial Extra Help was eliminated.

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.

To find out more about the assistance program in your state, you can call 800-MEDICARE or contact your State Health Insurance Assistance Program.

This story, originally published Jan. 28, 2022, was updated with the new eligibility numbers and changes to Extra Help in 2024.