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 Part D prescription drug plan.
Through the program, seniors could significantly improve their health and quality of life because they’ll be sure to get the medications they need.
We explain what the Extra Help program provides, who qualifies for it, and how to apply.
What the Extra Help program provides
The Extra Help program has two levels of coverage.
At the full level of assistance, seniors won’t pay any premiums or deductibles.
They’ll pay up to $4.15 for each generic drug and up to $10.35 for each brand-name drug. And once their total drug costs reach $7,400, they’ll pay $0 for each covered drug.
At the partial level of assistance, the premium will vary based on income and the deductible won’t exceed $104.
For prescriptions, seniors won’t pay more than 15% of the cost for each covered drug. And when total drug costs reach $7,400, they’ll pay at most $4.15 for each generic drug and $10.35 for each brand-name drug.
Who qualifies for the Extra Help program
Seniors get Extra Help automatically if they have:
- Full Medicaid coverage
- Help from their state paying the Part B premiums (from a Medicare Savings Program)
- Supplemental Security Income (SSI) benefits from Social Security
If they don’t get Extra Help automatically, seniors can apply for it.
In most cases, to qualify for Extra Help, applicants must have income and resources below a certain limit. The income limit is based on previous year’s income and goes up each year.
For 2023, the limits for individuals are $21,870 in income and $16,600 in resources. For married couples, the income limit is $29,580 and the resource limit is $33,240.
How to apply for the Extra Help program
Apply online here or call to speak with a Social Security representative at 1-800-772-1213.
Even if someone doesn’t qualify for Extra Help now, they can reapply for the program any time if their income and resources change.
Note: Caregivers can get more information on how to help seniors apply here
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
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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
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/
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.
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/
If you are three dollars over the Extra Help income limit they will not help you.
We’re so sorry to hear about this 🙁
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
So glad our articles are helpful!
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. 😌
Thanks for sharing your experience and tips with us!