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How to Know If You're Eligible for Medicare Extra Help

medicare-extra-help-eligibility

Medicare Prescription Drug Plans can make up a sizable portion of your out of pocket costs. Medicare Extra Help provides assistance to Medicare beneficiaries who are eligible. Read on to learn more about Medicare Extra Help and how to determine if you may qualify for this program.

What is Medicare Extra Help?

Medicare prescription drug coverage is available to anyone who is enrolled in a Medicare plan. Individuals with low income and limited assets may be eligible to get assistance with these costs through the Medicare Extra Help Program. In addition to standard costs set for generic and name-brand prescription drugs, eligible individuals may also receive help with Prescription Drug Plan, or Part D, premiums and deductibles.

How Do I Know If I’m Eligible for Medicare Extra Help?

If you fall into one of these three categories, you may be eligible for Medicare Extra Help:

  • You have a Medicare Savings Program
  • You receive Supplemental Security Income (SSI) benefits but don’t receive Medicaid
  • You’re eligible to receive both Medicaid and Medicare (dual eligibility)

Learn more about dual eligibility. It’s helpful to know that if you apply for Extra Help and aren’t eligible, you can always re-apply later.

Where Do I Apply for Medicare Extra Help?

Some individuals automatically receive Extra Help. If you need to apply, you have several options. You can complete an online application by visiting the Social Security Administration (SSA) website or request a paper application by calling 1-800-772-1213 (TTY: 1-800-325-0778). Stopping by your local Social Security office is always an option as well. Be sure to bring your Social Security Card, bank statements, and tax returns.

Do I Still Have to Enroll in a Prescription Drug Plan with Extra Help?

The short answer is yes. Enrolling in a Medicare Prescription Drug Plan is done separately from applying for Medicare Extra Help. The good news is that, if you qualify for Extra Help, you can enroll, drop or change Medicare Prescription Drug Plans at any time. That’s because if you qualify for Extra Help you may also be eligible for a Medicare Special Enrollment Period.

Get Assistance with Medicare Extra Help and More

Our Medicare Advocates are here to make Medicare easy, including finding a Medicare Prescription Drug Plan that works for you. They may also be able to help you find, compare, and enroll in Medicare plans. For assistance, call 1-800-991-4407 / TTY 711 from 10 a.m. to 9 p.m. ET, Monday through Friday.

You can also find and compare Medicare plans through our convenient Medicare Online Enrollment Portal.