How Seniors Can Get Help Paying for Prescription Drugs

get help paying for prescription drugs

Seniors can get help paying for prescription drugs

Some older adults aren’t able to follow their doctor’s instructions and take prescribed medication regularly because they can’t afford their prescriptions. The average adult over 65 years old takes 14 to 18 prescription medications in a year. Those costs really add up!

To help with medication costs, 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 $4000 per year through the Extra Help program.

People who qualify for the program will have low or no annual deductible, low or no monthly premiums, no “doughnut hole” coverage gap, and will pay much less for prescriptions. In 2015, most people who qualified paid less than $2.65 for generic and less than $6.60 for brand drugs.

We explain who qualifies for the Extra Help program and the 3 ways older adults can 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 $13,820 (individual or not living with spouse) or $27,600 (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 $18,090 (individual) or $24,360 (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

In some cases, older adults are automatically qualified for the Extra Help program.

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
  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 the application is submitted, Social Security will review it. 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.


Seniors can 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.


Bottom line

Many seniors have limited resources and struggle to pay their expenses, but there are many government programs that can help.

It’s well worth the time to investigate and help your older adult apply for programs like Extra Help. It could significantly improve their health and quality of life by making sure they can get the medications they need.


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


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By DailyCaring Editorial Team
Image: Discount Drug Network

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