Medicare has a program that helps pay for your prescription medicine. It’s called Medicare Prescription Drug Coverage or Medicare Part D. This program gives you a choice of prescription plans that offer various types of coverage. If you have enrolled or can enroll in Medicare Part D and you have limited income and resources, you may be able to get “Extra Help” with your prescription drug costs. This benefit is known as Medicare Part D Low-Income Subsidy (LIS) or Extra Help. Depending on your income and resources, you will have low or no deductible, low or no premiums, no coverage gap (also called the “doughnut hole”), and will pay much less for your prescriptions. Extra Help can provide you an average value of $4,900 per year. However, to get Extra Help, you must be enrolled in a Medicare Prescription Drug plan.
If you have Medicare and have limited income and resources, you may be able to get Extra Help paying for your prescription drug costs if:
Use the information below to find out more about the Extra Help program.
Please call 1-800-772-1213 (TTY 1-800-325-0778) for additional information or click here to learn more about Medicare Savings Programs.
How Can I Get Medicare Part D Low-Income Subsidy (LIS)/Extra Help?
To get Extra Help with Medicare prescription drug costs, you must complete and submit an application. The Social Security Administration (SSA) will review your application and send you a letter to let you know if you qualify for Extra Help. SSA will also send you information about the Medicare Prescription Drug Coverage and tell you what you should do next.
NOTE: To apply, you must live in one of the 50 States or the District of Columbia.
Who Should Apply for Extra Help?
You should complete an application for Extra Help if:
If you have more than those amounts, you may not qualify for the Extra Help. However, you can still enroll in an approved Medicare prescription drug plan for coverage.
Who Should Not Apply for Extra Help?
You should not complete an application if:
If you are in one of the 3 groups above, you will automatically get the Extra Help and do not need to apply.
Will This Application Enroll Me in a Medicare Prescription Drug Plan?
This is an application for Extra Help with Medicare prescription drug costs. It does not enroll you in a Medicare prescription drug plan. To get that coverage, you will have to enroll directly with an approved Medicare prescription drug plan. If you need information about Medicare Prescription Drug plans or how to enroll in a plan, call Medicare’s toll-free number 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048) or visit www.medicare.gov .
Can I Get Help If I Don’t Have a Medicare Prescription Drug Plan?
If you are found eligible for Extra Help and you have not yet enrolled in a Medicare Prescription Drug plan (Medicare Part D), you may temporarily get prescription drug coverage through Medicare’s Limited Income NET (LI NET) Program. This program was created by Centers for Medicaid and Medicare Services (CMS) to eliminate gaps in prescription drug coverage for low-income Medicare Beneficiaries. The LI NET program is temporary and can only help you for a short time (usually about 2 months). If after this time, you have not chosen a Medicare Part D plan, CMS will automatically enroll you into one.
Can I Get Help With Other Medicare Costs?
You may be able to get help from your State with other Medicare costs under the Medicare Savings Programs. These programs can save you up to $135.50 per month.
For security reasons, there are time limits on each page. After 45 minutes on a page, you must go to another page or your application session will end, and your work will be lost.
What Information Do I Need Before I Start My Application?
To find out if you could be eligible for Extra Help with Medicare prescription drug costs, Social Security needs information about your (and your spouse’s, if you are married and living together) income and resources. Documents that may help you prepare include:
This service is available during the following hours (Eastern Time):
Monday through Friday: 5:00 AM – 11:00 PM
Saturday: 5:00 AM – 9:00 PM
Sunday: 8:00 AM – 8:00 PM
Holidays: 5:00 AM – 9:00 PM
NOTE: Social Security accepts applications during certain hours. We recommend that you begin at least one hour before the latest time listed above to ensure your application will be processed.
Can I Get Help Completing This Application?
If you need help completing an application, click here to find a local agency in your community, or call Social Security toll-free at 1-800-772-1213 (TTY 1-800-325-0778).