Get Help Paying for Medicare Premiums, Deductibles, Copays

If you apply first for Extra Help, your application is automatically forwarded to your state to determine eligibility for a Medicare Savings Program.

U.S. territories don’t have Medicare Savings Programs, but their Medicaid programs may provide financial assistance.

See Medicaid.pr.gov in Puerto Rico and the Medical Assistance Program in the U.S. Virgin Islands and each territory’s SHIP: Programa Estatal de Asistencia sobre Seguros de Salud in Puerto Rico and Virgin Islands State Health Insurance Assistance Program. Medicaid.gov has multiple phone numbers for each state’s and territory’s Medicaid office.

Extra Help pays for some Part D premiums, expenses

The federal government’s Extra Help program can pick up the tab for a large share, an average of $5,700, of your annual Medicare Part D premiums, deductibles and copayments in 2026.

You get it automatically if you have full Medicaid coverage, qualify for certain Medicare Savings Programs or receive Supplemental Security Income (SSI) benefits from Social Security. If you don’t get Extra Help automatically, you can apply through the Social Security Administration (SSA).

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.

Extra Help can cover your Part D premium, which varies depending on where you live, eliminate your Part D deductible and limit what you pay at the pharmacy.

A 2024 law, which AARP supported, expanded eligibility for Extra Help. Full benefits are now available to Medicare beneficiaries with limited resources and incomes below 150 percent of the federal poverty level, a dollar amount that’s adjusted annually for inflation and 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.

Be aware that Extra Help applications ask for annual income, so your monthly income can vary. It can be as much as $2,015 a month for an individual and $2,725 for married couples in 2026. Medicare Savings Programs look at current monthly income.

As with Medicare Savings Programs, if you own a home and a car, bought a burial 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. Use the Medicare Plan Finder to choose one that covers your medications.

The Extra Help program also is not available in U.S. territories. But a territory’s Medicaid office may be able to assist.

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, 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 for your Part D plan or Medicare Advantage plan with prescription coverage and medication costs up to a $2,100 limit for covered drugs in 2026.

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 $175 each of 12 months rather than $2,100 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 Part D or Medicare Advantage drug plan.

Explore state-run, private drug benefit programs

These other programs work outside of private insurers’ Medicare Part D and Medicare Advantage plans with drug coverage. 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.

Put on your bargain-hunter hat. You may find better deals on your medications through these programs. You might not.

Be aware: These programs are not the prescription insurance equivalent of a Part D plan, so keep or enroll in Part D to avoid penalties. They don’t generally add discounts on top of your insurance price and won’t count toward 2026’s $2,100 limit in annual out-of-pocket costs for covered drugs.

State prescription programs. If you don’t qualify for Extra Help or you want to supplement its benefits, you may be eligible for a state pharmaceutical assistance program (SPAP) that can help with your prescription costs.

Only five states — Alaska, Hawaii, Nebraska, Oklahoma and West Virginia — lack such plans, according to the Medicare’s state pharmaceutical assistance program finder; the District of Columbia and Puerto Rico are included. Each program works differently, and some states have several to target specific needs, but most are for people with HIV or AIDS.

Fourteen states — Delaware, Indiana, Maine, Maryland, Massachusetts, Missouri, New Jersey, New Mexico, New York, Pennsylvania, Rhode Island, Texas, Vermont and Wisconsin — go beyond HIV medications, with varying income restrictions.

To find out more, can call 800-MEDICARE or contact your State Health Insurance Assistance Program.

State discount programs. At least seven states — Arizona, California, Connecticut, Michigan, Nevada, Oregon and Washington — sponsor state prescription discount programs, sometimes in the form of cards or clubs.

The design of the programs varies among states.

• California and Michigan contract with pharmacy benefit managers to negotiate drug prices between manufacturers and insurers and determine the payments that pharmacies receive.
• Washington and Oregon started a nonprofit, now called ArrayRx, that provides an electronic prescription discount card for residents. The program also serves Arizona, Connecticut and Nevada residents.

Beware: You will also find state-branded discount-card websites for most states. They are privately run programs that also negotiate prices through pharmacy benefit managers or discounters but aren’t affiliated with state governments.

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.

Medicare’s pharmaceutical assistance program finder works with Part D plans and allows you to search by your drug name. RxAssist is an additional database, searchable by drug or company name, that includes manufacturers offering free or reduced-price medication to under- or uninsured people who cannot afford their prescriptions.

Prescription discount cards. Private companies such as GoodRx, Optum Rx, Single Care and WellRx have relationships with multiple pharmacy benefit managers to offer discounts on brand-name and generic medications at retail pharmacies such as CVS, Walgreens and Walmart and grocery store pharmacies.

The TrumpRx website offers drugstore coupons for brand-name prescriptions or links to manufacturers’ websites to purchase directly, using technology from GoodRx.

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

Warehouse clubs and online pharmacies. Two of the country’s three largest warehouse club chains — Costco and Sam’s Club — operate in-store and online pharmacies with discounted prices. They don’t require memberships to buy prescriptions.

Pharmacies such as Amazon Pharmacy, based in Austin, Texas; New York-based BlinkRx; and Dallas-based Mark Cuban Cost Plus Drug Co. ship medications nationwide. The federal Food and Drug Administration has resources for consumers on buying medicines safely from online pharmacies.

Check for generic equivalents for your medications. When they’re available, they’re often significantly less expensive than name brands. Search each website to see the cost of your prescriptions before you buy.

Most of these websites, clubs and online pharmacies work independently of Part D plans. Purchases are with cash or credit card and won’t count toward your out-of-pocket limit.

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