Extra Help with Medicare Costs
Apply for help—even if you aren’t sure you qualify
You may qualify for extra help to pay for certain Medicare premiums, deductibles, and copayments. A quick visit to the Social Security Administration website can tell you if you're eligible, and you can even apply online.
Who qualifies for extra help automatically?
You receive extra help with Medicare costs automatically if you have Medicare and also have:
- Programs of All-inclusive Care for the Elderly (PACE)
- Medicare Savings Programs
- Supplemental Security Income (SSI) benefits
How do I find out if I qualify for extra help?
Visit the Social Security Administration website at www.ssa.gov/prescriptionhelp. Click on See if you qualify for Extra Help, and answer the questions listed on the application. If you’re eligible, you can go straight to the Apply Now tab.
You can also get the simple, four-page application from your local Social Security office or call the SSA at 1-800-772-1213, (TTY: 1-800-325-0778) Monday – Friday, 7 a.m. to 7 p.m.
What kind of help is available?
Depending on your income, resources, and other factors, you may be eligible for certain federal, state, and local programs that help with Medicare beneficiaries' medical costs. These programs include:
- Help with prescription drug costs* – The federal government helps millions of Medicare beneficiaries pay their prescription drug costs. Those who qualify for extra help enjoy free or reduced drug coverage premiums and reduced out-of-pocket costs. Some people qualify for prescription drug help automatically, while others need to apply.
- Medicaid – This joint state and federal program helps people with limited income and resources pay for healthcare. For information about Medicaid, call your State Medical Assistance office. You can find the number on the Medicare website. Or call 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week. (TTY users call 1-866-653-4261)
- Programs of All-inclusive Care for the Elderly (PACE) – This program offers a combination of medical, social, and long-term-care services. It is available only in states that choose to offer it under Medicaid. Eligibility requirements vary from state to state. For details, contact your State Medical Assistance office.
- Medicare Savings Programs – Under this program, your state Medicaid program helps you pay your Medicare premium and, in some cases, your deductibles and coinsurance. Millions of people receive help through Medicare Savings Programs, which have different names in different states. For more information, call your State Medical Assistance office.
- Supplemental Security Income (SSI) benefits – This is help for people who are disabled, blind, or over age 65 AND have limited financial resources. SSI is NOT the same as Social Security benefits. For more information, call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778) 24 hours a day, 7 days a week, or contact your local Social Security office. You can also use the Benefits Eligibility Screening Tool (BEST) on the Social Security website to find out if you're eligible.
*Applying for extra help is NOT the same as joining a prescription drug plan. Whether you qualify for extra help or not, you must also enroll in a plan to get prescription drug coverage.
It is important to remember that applying for extra help is NOT the same as joining a prescription drug plan. Whether you qualify for extra help or not, to get prescription drug coverage you have to choose to enroll in a Medicare Advantage plan with prescription drug coverage or a stand-alone prescription drug plan.