Extra Help With Medicare Drug Costs: Who Qualifies and How to Apply

If paying for your prescriptions takes a big bite out of your monthly budget, a Medicare program called Extra Help is worth a look. It can lower your Part D drug costs, or cut them to almost nothing, and applying is free.

With Medicare Open Enrollment running from October 15 to December 7, this is a good time to check whether you qualify.

What Extra Help Does

Extra Help is for people with Medicare who have limited income and savings. Social Security runs the application. If you qualify, Medicare.gov says you get:

• A Medicare drug plan with a $0 premium and a $0 deductible (you can pick a different plan, but you may pay more)
• Low copays: for 2027, no more than $5.80 for each generic drug and $14.40 for each brand-name drug at participating pharmacies
• $0 for each covered drug once your total drug costs reach $2,400 for the year
• The chance to change your drug coverage once a month, not just during Open Enrollment

Who Qualifies

For 2026, Medicare lists these limits:

• Income: below $23,940 a year for one person, or $32,460 for a married couple
• Resources: below $18,090 for one person, or $36,100 for a married couple

“Resources” means things like checking and savings accounts, retirement accounts, stocks and bonds. Your home, one car, household items, burial plots and up to $1,500 set aside for burial costs don’t count. Limits are higher in Alaska and Hawaii, and they may change each year.

You get Extra Help automatically, without applying, if you have full Medicaid coverage, get help from your state paying your Part B premium (a Medicare Savings Program), or receive Supplemental Security Income (SSI).

How to Apply

1. Gather a few papers for you and your spouse: bank statements, tax returns, and statements for any pensions, annuities, IRAs or 401(k)s.
2. Apply online at ssa.gov/extrahelp, or call Social Security at 1-800-772-1213 (TTY 1-800-325-0778), Monday to Friday, 8 a.m. to 7 p.m.
3. Watch your mail. Social Security sends a letter telling you whether you qualify.

If your income or savings drop later, you can apply again at any time.

Free, Trusted Help

Your State Health Insurance Assistance Program (SHIP) gives free, unbiased Medicare help and can walk you through the application. Find yours at shiphelp.org. You can also call 1-800-MEDICARE (1-800-633-4227).

A word of caution: applying for Extra Help is always free. Anyone who calls out of the blue offering to “sign you up” for a fee, or who asks for your Medicare or bank details, is likely a scammer. Social Security says it will never ask for sensitive information by text, email or social media.

Rules and amounts can change, and your own situation matters, so check with Social Security or a SHIP counselor before making decisions.

More on Seniors Tips

• Medicare Open Enrollment 2026: A Step-by-Step Guide to Reviewing Your Coverage
• Medicare Open Enrollment Scams: Red Flags and What to Do

Sources

• Medicare.gov: Help with drug costs
• Medicare.gov: Extra Help (CMS Product No. 12200, April 2026)
• Social Security Administration: Extra Help with Medicare prescription drug plan costs
• Social Security Administration: Protect yourself from scams
• SHIP National Technical Assistance Center: Find your local SHIP