Congress set aside funds to help low income Medicare beneficiaries receive financial assistance with their Part D plans. Known as “Extra Help” or the Low Income Subsidy, these funds are managed by the Social Security Administration. Individuals may qualify for a full or partial subsidy depending on income and assets. The Low Income Subsidy can help pay for beneficiary's drug premiums, deductibles and co-payments. Some Medicare beneficiaries qualify for the Low Income Subsidy automatically, including:
people who are enrolled in Medicaid (sometimes called “dually eligible”)
people who receive Supplemental Security Income (SSI)
people in a Medicare Savings Program (MSP)
Although some qualify automatically, anyone can apply through the Social Security Administration by calling 1-800-772-1213 or by using their online application for Extra Help. Don't make the common mistake of confusing the low-income subsidy application with enrollment in a Medicare prescription drug plan. They are separate processes run by entirely different entities.
If you are low income and have few assets, it’s also a good idea to see if you might qualify for your state Medicaid program. You can apply on Healthcare.gov or contact your state Medicaid office. Your state Medicaid office also administers the Medicare Savings Program, a little-known assistance programs that helps income-eligible Medicare beneficiaries pay for Medicare premiums, deductibles, and co-payments for part A and B.
State Patient Assistance Programs
Another possible source of assistance for Medicare beneficiaries with high drug costs are State Patient Assistance Programs, or S-PAPs. Unfortunately, not all states have S-PAPs, and some are limited to Medicare beneficiaries over age 65. Check with the Medicare Rights Center to learn if an S-PAP can help you.
It is always a good idea to keep copies of any application for any type of assistance you apply for, especially since it will take time to gather all of the documents you will need. Having a copy of your first application will save you time if you apply later, or to another program.
Patient Assistance Programs
The manufacturers of the different disease modifying therapies each have a Patient Assistant Program that may offer assistance for people on a Medicare Prescription Drug Plan who meet their income guidelines. There are also several nonprofit organizations that can help lower prescription costs for people with Medicare. Visit our prescription assistance page for more information about these programs.