How Seniors Can Get Help Paying for Prescription Drugs

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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 prescription drug plan. 

Seniors could get an extra $5,000 per year, significantly improving health and quality of life by making sure they can get the medications they need.

People who qualify for the program will have low or no annual deductible, low or no monthly premiums, no “Medicare donut hole” coverage gap, and will pay much less for prescriptions.

We explain who qualifies for the Extra Help program and the 3 ways for seniors to apply.

Who qualifies for the Extra Help program

To qualify for Extra Help, seniors must:

• Be on Medicare Part A and/or Part B
• Live in one of the 50 states or in the District of Columbia
• Have combined assets (like bank accounts, investments) less than $14,390 (individual or not living with spouse) or $28,720 (married living with spouse) – don’t include your home, vehicles, possessions, life insurance, burial plots/contracts, or back payments for Social Security or SSI
• Have annual income less than $18,735 (individual) or $25,365 (married living with spouse)

Even if your older adult’s annual income is higher than these guidelines, they may still be able to qualify for some help. Apply online or speak with a Social Security representative.

Some seniors automatically qualify for Extra Help

Seniors who have Medicare and Supplemental Security Income (SSI) or Medicare and Medicaid will automatically get the extra help.

They don’t need to apply.

3 ways to apply for the Extra Help program

For older adults who are eligible, there are three ways to apply for Extra Help:

1. Apply online at www.socialsecurity.gov/extrahelp
2. Call Social Security at 1-800-772-1213 to apply over the phone or to request an application
3. Apply at the local Social Security office

After Social Security reviews the application, your older adult will get a letter to let them know if they qualify and, if they do, what to do next to start getting benefits.

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

Seniors could get back some of what was already spent on prescriptions

Once they’re in the Extra Help program, some older adults might even be able to get back part of what they already spent on prescriptions since they qualified.

Keep the receipts and call the plan or contact Medicare’s Limited Income Newly Eligible Transition (NET) Program at 1-800-783-1307 to find out more.

Next Step  Apply for the Extra Help program to get help with prescription drug costs

Recommended for you:

• 7 Ways for Seniors to Reduce Prescription Drug Costs
• 5 Ways to Afford Prescriptions in the Medicare Donut Hole
• Benefits Programs Help Pay for Caregiving Expenses

By DailyCaring Editorial Team
Image: Discount Drug Network

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