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How Seniors Can Get Help Paying for Prescription Drugs

Seniors can get help paying for prescription drugs through a Social Security program called Extra Help

Seniors can get help paying for prescription drugs

When older adults aren’t able to afford their prescriptions, they can’t follow the doctor’s instructions and take necessary medication.

To get help paying for prescription drugs, Social Security has a program called Extra Help With Medicare Prescription Drug Costs.

It pays for costs related to a Medicare Part D prescription drug plan.

Through the program, seniors could significantly improve their health and quality of life because they’ll be sure to get the medications they need.

We explain what the Extra Help program provides, who qualifies for it, and how to apply.


What the Extra Help program provides

The Extra Help program has two levels of coverage. 

At the full level of assistance, seniors won’t pay any premiums or deductibles. 

They’ll pay up to $4.15 for each generic drug and up to $10.35 for each brand-name drug. And once their total drug costs reach $7,400, they’ll pay $0 for each covered drug.

At the partial level of assistance, the premium will vary based on income and the deductible won’t exceed $104.

For prescriptions, seniors won’t pay more than 15% of the cost for each covered drug. And when total drug costs reach $7,400, they’ll pay at most $4.15 for each generic drug and $10.35 for each brand-name drug.

Who qualifies for the Extra Help program

Seniors get Extra Help automatically if they have:

  1. Full Medicaid coverage

  2. Help from their state paying the Part B premiums (from a Medicare Savings Program)

  3. Supplemental Security Income (SSI) benefits from Social Security

If they don’t get Extra Help automatically, seniors can apply for it.

In most cases, to qualify for Extra Help, applicants must have income and resources below a certain limit. The income limit is based on previous year’s income and goes up each year.

For 2023, the limits for individuals are $21,870 in income and $16,600 in resources. For married couples, the income limit is $29,580 and the resource limit is $33,240.


How to apply for the Extra Help program

Apply online here or call to speak with a Social Security representative at 1-800-772-1213.

Even if someone doesn’t qualify for Extra Help now, they can reapply for the program any time if their income and resources change.

Note: Caregivers can get more information on how to help seniors apply here

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By DailyCaring Editorial Team

This article wasn’t sponsored and doesn’t contain affiliate links. For more information, see How We Make Money.


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