Medicare Extra Help to pay for drugs

Who is eligible for Medicare Extra Help?

First, you’ll need Medicare drug coverage (Part D). To get Part D, you must have at least one part of Original Medicare (Medicare Part A, Medicare Part B or both), have legal presence in the U.S. and live in the plan’s service area. You must also live in one of the 50 states or the District of Columbia to enroll in Medicare Part D Extra Help. You may qualify for Extra Help with your plan if you have up to:

These amounts are for 2025. They may change in 2026. If your income and resources are a bit higher, you should still apply.

How to prove you receive Medicare Extra Help

The Centers for Medicare and Medicaid Services (CMS) has policies that help you prove you receive Medicare Extra Help. The Best Available Evidence policy (BAE) helps ensure people with Part D do not pay more than expected. Once eligibility is proven, BAE states that sponsors must accept it. The following are usable examples in a BAE case:

• A Medicaid card
• A Social Security Administration Award Letter
• A state document (or copy of one) that shows you have Medicaid
• A screenprint from the Medicaid system showing active Medicaid status
• A printed copy of a state electronic enrollment file showing Medicaid status
• Other state documents showing Medicaid eligibility status 
• An “Application Filed by Deemed Eligible” notice from Social Security confirming automatic eligibility for Extra Help based on SSI
• A copy of a state-approved Home and Community-Based Services (HCBS) plan with your name and the effective date