Medicare Extra Help to pay for drugs

Who qualifies for Medicare Extra Help?

First, you’ll need Medicare Part D drug coverage. To get Part D:
 

• You need to have at least one part of Original Medicare (Medicare Part A, Part B or both)
• You must live in one of the 50 United States or the District of Columbia
• You must have legal presence in the U.S. and live in the plan’s service area

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. Get more details to see if you qualify for Extra Help.

How to prove you get Medicare Extra Help

If you get Extra Help and you think you’re paying an incorrect cost share for your drugs at the pharmacy, you have options.

Based on the federal Best Available Evidence (BAE) policy, you can send any one of these documents to have us reassess your Part D cost share:

• 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