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 $14,790 (individual or not living with spouse) or $29,520 (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 $19,320 (individual) or $26,130 (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 so 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:
- Apply online at www.ssa.gov/benefits/medicare/prescriptionhelp/
- Call Social Security at 1-800-772-1213 to apply over the phone or to request an application
- 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:
- Financial Help for Seniors: 2,500+ Federal, State, & Private Benefits Programs
- 5 Options for Medications Not Covered by Medicare
- 7 Ways for Seniors to Reduce the Cost of Prescription Drugs
By DailyCaring Editorial Team
Image: Discount Drug Network
This article wasn’t sponsored and doesn’t contain affiliate links. For more information, see How We Make Money.
Teresa Brown
I received the so called “Extra Help” and it is still the same price with the deductibles even if they do cover it. It sucks so don’t fall for the avalanche of calls text and emails you receive. there is no help for seniors unless you are welfare
DailyCaring
We’re sorry to hear that the Extra Help program didn’t provide enough financial assistance in your situation.
In case it’s helpful, you may be eligible for other benefits programs that could help with other expenses – Financial Help for Seniors: 2,500+ Federal, State, & Private Benefits Programs https://dailycaring.com/find-financial-help-for-seniors-federal-state-and-private-benefits-programs/
Bette Davis
I’m a 68 year woman in need of an antibiotic called Tobi. I am one of the oldest survivors in Texas with Cystic Fibrosis. I cannot pay the deductible of 1000.00 to get this medicine. And I need it badly. I have a lung infection. I don’t know what to do. If you could point me in the right direction for help, I would greatly appreciate it. Thanks…. Bette Davis.
DailyCaring
We’re so sorry to hear about this situation. Hopefully the Medicare Extra Help program described in the article above can offer some help.
You might also want to contact your doctor to find out if there are any programs from drug manufacturers that could help you get the medication you need.
We’ve got a few more articles with suggestions to get help paying for medication that might be helpful:
– 5 Options for Medications Not Covered by Medicare https://dailycaring.com/5-steps-to-take-when-medications-are-not-covered-by-medicare/
– 5 Ways to Afford Prescriptions in the Medicare Donut Hole https://dailycaring.com/5-ways-to-afford-prescriptions-in-the-medicare-donut-hole/
– 7 Ways for Seniors to Reduce the Cost of Prescription Drugs https://dailycaring.com/7-ways-to-save-money-on-prescription-drugs/
You might also want to contact your local Area Agency on Aging. They may be able to connect you to organizations that can help. More info here – Area Agency on Aging: Resources for Seniors https://dailycaring.com/area-agency-on-aging-resources-for-seniors/
Anonymous
If you are three dollars over the Extra Help income limit they will not help you.
DailyCaring
We’re so sorry to hear about this 🙁
Anonymous
Wow what a great site to land on and so much great information.. I have bee6so frustrated on who or what to to help me these high copays on have.. Never have had such high copays even when I was working and now I see a light at the end of my tunnel
DailyCaring
So glad our articles are helpful!
Kara
I am thankful for programs like these bc they do help alot & even more for others. If you dont think you qualify or are eligible, apply anyway bc usually you’re wrong & can get the help. It’s always better to apply for the help if you need it bc the worst thing they can say is no & no harm done, otherwise you may be missing out on help that you could get that would help & could possibly even make a world of difference. I care for my grandmother & I have learned that its there for anyone who needs it & even those that don’t know they need it. Sometimes it’s better to sign up for programs you qualify for even if you don’t think you need help bc that very well may be what saves you down the road & keeps you from ending up struggling to get by. You never know what the future holds & it’s not always what we plan that’s for sure. So it’s just smart to utilize these programs if we qualify,in order to be able to live better. My grandparents have been the type to not need help my whole life & were usually the ones trying to help others as much as they could but my granddad’s been gone for 9 yrs & I think I was prolly the only thing that went as planned since (I find legal papers a yr after moving in & he had named me as POA /executor). Honestly I don’t think they knew exactly how wide of a range of programs existed beyond snap & such. She thought she wouldn’t qualify. I’m not saying someone should go sign up for every single program put there but if I come across a program that I feel might benefit her in more than 1 way then it’s not gonna hurt to see if she qualifies. It’s my job as her caregiver to make her life better if I can & to do what benefits her any way I can. That should be what most caregivers want for their older adult. Make the remainder of the years they have left with us as enjoyable & stress-free as possible. So you do whatever to make it happen. Honestly that’s why programs have the criteria they go by so they know the ones that qualify need it. Sry for rattling on but point is theres alot of seniors out there that need help or could use some help & don’t realize there’s programs that are available for pretty much everything & like extra help is amazing but make sure u understand the terms & how it works bc I first thought it wasn’t worth it but after I found out that some ppl have a deductible to meet each yr before it drops to plan pricing. Soon as it’s met, her Rxs are $0 for several & under $5 with 1-2 under $15. It’s all dependent on what you meds u take so look it up before so u know what to expect. u gotta inform urself & if u don’t understand ask someone to help u. U get out what u put in at times too. 😌
DailyCaring
Thanks for sharing your experience and tips with us!