Medicare Extra Help FAQs

1. First, you have to qualify for Extra Help.

You may qualify for Extra Help if you have a plan with Medicare drug coverage (Part D) and you also have:
 

• Limited resources
• An income at or below 150 percent of the federal poverty level

2. You may need to apply to get Extra Help.
 

If you qualify, you may need to apply to get Extra Help. Others may not need to. Read more on the question How do you apply for Extra Help?
 

3. You’ll see the benefits when it’s time to fill your prescriptions.
 

Once you’re approved for Medicare Extra Help, benefits include:
 

• A $0 or reduced Medicare drug plan premium
• A $0 annual Medicare drug plan deductible
• A reduced amount for covered generic and brand-name drugs
• No Part D late enrollment penalty

You’ll need Medicare drug coverage (Part D) to get Extra Help. You may qualify for Extra Help if your income and resources are at or below:
 

• $23,475 in yearly income ($31,725 for a married couple)
• $17,600 in resources ($35,130 for a married couple)

The Medicare Extra Help program defines “resources” as your funds in any:
 

• Checking, savings or retirement accounts
• Stocks
• Bonds
• Mutual funds
• Real estate
• Individual Retirement Accounts (IRAs)
• Cash you keep at home or elsewhere

Are your income and resources slightly higher? You should still apply.
 

These amounts are for 2025. They may change in 2026. We’ll post any changes to these amounts once the Centers for Medicare & Medicaid Services (CMS) posts them. Make sure to check back in early 2026 for updates.
 

For more on how to qualify, you can call or visit:
 

• The Social Security Administration at 1-800-772-1213 (TTY users should call 1-800-325-0778), Monday to Friday, 8 AM to 7 PM.
  
• Social Security Administration website

Do you have to apply to get Extra Help from Medicare?
 

You may need to apply to get Medicare Extra Help. If so, we can help you apply.

But you may not need to apply. You don’t need to apply to get Extra Help if you:
 

• Are eligible for Medicare and Medicaid
• Get state help to pay your Part B premiums
• Get Supplemental Security Income (SSI) payments from Social Security

There are a few ways to apply for Extra Help. Here are three ways to start:
 

• If you’re an Aetna member, you can call BeneLynk. They can help you apply for Extra Help over the phone. Call them at 1-888-715-0225 ${tty}, Monday to Saturday, 8 AM to 8 PM local time.
• Apply online on the Social Security Administration website.
• Apply by calling Social Security at 1-800-772-1213 (TTY: 1-800-325-0778), Monday to Friday, 8:00 AM to 5:30 PM.

But you may not need to apply. You don’t need to apply to get Extra Help if you:
 

• Are eligible for and Medicaid
• Get state help to pay your Part B premiums
• Get Supplemental Security Income (SSI) payments from Social Security