What do I need to know about the Medicare Part D Extra Help Program?
Medicare Extra Help can lower your Medicare Part D prescription drug costs, including premiums, deductibles and copays. Learn who may qualify, how the program works and the different ways you can apply for Extra Help.
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Medicare Extra Help is a federal program that helps eligible people pay for Medicare prescription drug costs. Qualification is generally based on your income, savings and other financial resources. Some people may qualify automatically if they already receive certain types of financial assistance, such as Medicaid or Supplemental Security Income (SSI).
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Medicare Part D helps to cover your prescription drugs. If you have a plan with Part D coverage but need more help to pay for your drugs, you may qualify for Extra Help.
Medicare Extra Help may help lower out-of-pocket drug costs like your:
- Premiums
- Copays
- Coinsurance
For 2026 plans:
Extra Help also waives any Part D late enrollment penalty.
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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
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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:
- $23,940 in yearly income ($32,460 for a married couple)
- $18,090 in resources ($36,100 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 2026. They may change in 2027. We’ll post any changes to these amounts once the Centers for Medicare & Medicaid Services (CMS) posts them. Make sure to check back in January 2027 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
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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
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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
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Qualifying for Medicare Extra Help may change the costs you pay for prescription drug coverage. You may want to compare Medicare Advantage plans that include prescription drug coverage to see which plans best fit your medications, providers and budget. Review plan details carefully before making changes to your coverage.
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Yes, you can apply for Medicare Extra Help again if your financial situation changes. If your income or resources go down in the future, you may qualify even if you did not qualify before. Review the current eligibility guidelines before reapplying.
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Medicare Extra Help lowers prescription drug costs, but it does not limit your Medicare coverage choices. You can still compare Medicare Advantage plans, Medicare Part D prescription drug plans and other coverage options. Review plan costs, drug coverage and provider networks to choose the coverage that fits your needs.
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If you do not qualify for Medicare Extra Help, you may still have other ways to lower your prescription drug costs. Some Medicare Advantage plans and Medicare Part D plans may offer lower prescription drug costs or preferred pharmacy savings. You may also qualify for state financial assistance programs or manufacturer assistance programs.
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Medicare Extra Help and dual-eligible plans are different programs. Qualifying for Extra Help does not automatically mean you qualify for a dual-eligible special needs plan (D-SNP). Dual-eligible plans are for people who qualify for both Medicare and Medicaid.
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Getting SNAP benefits does not automatically qualify you for Medicare Extra Help or a dual-eligible plan. However, SNAP benefits may indicate that you could qualify for other Medicare financial assistance programs. Review the income and eligibility requirements for Medicare Extra Help and Medicaid to learn more.
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