If you meet certain income and resource limits, you may qualify for Extra Help from Medicare to pay the costs of Medicare prescription drug coverage.
In 2018, costs are no more than $3.35 for each generic/$8.35 for each brand-name covered drug.
Other people pay only a portion of their Medicare drug plan premiums and deductibles based on their income level.
In 2018, you may qualify if you have up to $18,210 in yearly income ($24,690 for a married couple) and up to $14,100 in resources ($28,150 for a married couple).
If you don’t qualify for Extra Help, your state may have programs that can help pay your prescription drug costs. Contact your Medicaid office or your State Health Insurance Assistance Program (SHIP) for more information. Remember, you can reapply for Extra Help at any time if your income and resources change.
Countable resources include:
Countable resources don’t include:
You automatically qualify for Extra Help if you have Medicare and meet any of these conditions:
Even if you automatically qualify this year, you may not qualify for Extra Help next year. Changes in your income or resources may cause you no longer to qualify for one of the programs listed above. You’ll get a notice (on grey paper) by the end of September if you no longer automatically qualify. Even if you get this notice, you may still qualify, but you need to apply to find out.
If you’re not sure if you’re paying the right amount, call your drug plan. Your plan may ask you to give information to help them check the level of Extra Help you should get. Get your plan’s contact information from a Personalized Search (under General Search), or search by plan name.
If you paid for prescriptions since you qualified for Extra Help and you aren’t enrolled in a Medicare drug plan, you may be able to get some money back. Keep your receipts, and call your plan. Or, you can contact Medicare’s Limited Income Newly Eligible Transition (NET) Program at 1-800-783-1307 for more information (TTY: 711).