What Is the Part D Extra Help Program — And How to Apply

Prescription drug costs are one of the biggest financial concerns for Medicare beneficiaries. Many people pay far more than they need to simply because they are not aware of a federal program designed to help cover those costs.

It is called Extra Help. It is real, it is significant, and millions of people who qualify are not enrolled.

What Is Extra Help?

Extra Help is a federal program run by the Social Security Administration. It is designed to help people with Medicare pay for prescription drug costs including monthly premiums, annual deductibles, and copayments associated with a Medicare Part D prescription drug plan.

In 2025 the value of Extra Help is estimated at over $5,000 per year for those who qualify. This is not a small benefit. For many seniors on fixed incomes it can make an enormous difference in their monthly budget.

Who Qualifies?

To qualify for Extra Help you generally need to meet income and resource limits set by the federal government. These limits are updated each year.

As a general guideline for 2025 you may qualify if your annual income is below approximately $22,000 as an individual or $30,000 as a married couple. Resource limits including savings and investments also apply though your primary home, one vehicle, and life insurance policies are typically not counted.

These numbers are approximate. The only way to know for certain whether you qualify is to apply or speak with a licensed advisor who can review your situation.

What Does Extra Help Actually Cover?

If you are approved for Extra Help the program helps pay for:

Your monthly Part D premium up to a benchmark amount set by Medicare. Your annual Part D deductible. Your copayments and coinsurance costs when you pick up prescriptions at the pharmacy.

The level of help you receive depends on your income and resources. Some people receive full Extra Help and pay very little out of pocket for their medications. Others receive partial assistance but still see significant savings.

How to Apply

There are three ways to apply for Extra Help:

Online: Visit socialsecurity.gov and complete the application through their website. It typically takes about 30 minutes.

By phone: Call Social Security at 1-800-772-1213. Representatives are available Monday through Friday and can walk you through the application over the phone.

In person: Visit your local Social Security office. Bring proof of income, bank statements, and your Medicare card.

You can also apply through your state Medicaid office as qualifying for Medicaid automatically qualifies you for full Extra Help.

What Happens After You Apply?

Social Security will review your application and mail you a decision letter. If you are approved your Extra Help benefits will be applied to your Part D plan automatically. You will also have the option to switch to a plan that better fits your needs during a Special Enrollment Period.

If you are denied you have the right to appeal the decision.

Do Not Leave This Money on the Table

Millions of Medicare beneficiaries qualify for Extra Help and never apply. Many do not know it exists. Others assume they make too much money to qualify without ever checking. The application is free, takes less than an hour, and could save you thousands of dollars per year.

At Aegis Sage we help Medicare beneficiaries in New Jersey, New York, and Pennsylvania understand every benefit available to them. If you want help understanding whether you qualify for Extra Help or any other Medicare assistance program, call us at (929) 888-7348 or visit aegissage.com to schedule a free consultation.

Not affiliated with or endorsed by the government or Federal Medicare program. We do not offer every plan available in your area. Currently we represent multiple organizations which offer multiple products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your State Health Insurance Program (SHIP) to get information on all your options.