Extra Help for Prescription Drug Coverage
Extra help for prescription drug coverage is available for people with Medicare who have limited income and resources. If eligible for extra help, Medicare will pay for almost all prescription drug costs. Extra help provides a subsidy based on the amount of income and resources a person has.
Full Subsidy Benefits from Extra Help:
Full premium assistance up to the premium subsidy amount
Nominal cost sharing up to out-of-pocket threshold
No coverage gap
Other Low Income Subsidy Benefits from Extra Help:
Sliding scale premium assistance
Reduced deductible
Reduced coinsurance
No coverage gap
An individual who has Medicare and Medicaid does not need to apply for extra help from Social Security. An individual who is eligible for the Medicare Savings Program (MSP) does not need to apply for extra help from Social Security. The MSP-eligible individual's information is sent to CMS automatically for the extra help.
Eligibility specialists ask, "Can I screen you for eligibility for Medicare Savings Program (MSP) since certification would include eligibility for extra help?"
If the caller does not want to be screened for MSP, refer the caller to the Centralized Benefit Services, 1-800-248-1078, for completion of subsidy application.
If an individual thinks personal information is being misused, call 1-800-MEDICARE ( 1-800-633-4227 ).
Apply for extra help or get more information about extra help subsidy by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or visiting www.ssa.gov .