Extra Help can help those with limited income and resources pay for Medicare Part D. To qualify in 2024, you must make less than $22,590 and have less than $17,220 in resources. Married couples must make less than $30,660 and have less than $34,360 in joint resources.

If you need help paying for the costs of your Medicare Part D prescription drug plan, you might qualify for assistance through a program called Extra Help. To qualify for Extra Help, you need to meet certain financial requirements.

Read on to learn about Medicare’s Extra Help program, including this year’s income limits, how to qualify, enrollment information, and more.

When you have a Medicare Part D prescription drug plan, you’re responsible for monthly premiums, deductibles, copayments, and coinsurance amounts.

Medicare Extra Help can help you pay some or all of those costs.

The program is overseen by the Social Security Administration (SSA) and is based on income. The SSA estimates that program participants can save as much as $5,900 annually.

The Medicare Extra Help program is designed to help limited-income beneficiaries pay for their medications. To qualify, Medicare requires that you meet a few requirements.

First, you’ll need to be eligible for Medicare and enrolled in parts A and B, also called Original Medicare. Next, you’ll need to meet the income qualifications.

The Medicare Extra Help income limits are set based on the government standard called the federal poverty level (FPL). This standard is redetermined yearly and considers factors like the cost of living and average income in each state.

The FPL helps the government set qualifications for programs like Medicaid, housing assistance, and Medicare Extra Help. This means the income limits for Extra Help might change slightly each year as the FPL adjusts.

You’ll need to meet the current limit to qualify for the program.

In 2024, you must have an income of less than $22,590 if you’re single. If you’re married and live with your spouse, your combined income must be less than $30,660.

However, if your income is slightly higher, you might still qualify in certain cases. Examples include:

  • living in Alaska or Hawaii
  • supporting a dependent family member
  • having earnings from work you’ve done

Plus, Medicare doesn’t count all the payments you receive in a year toward the income limit.

Let’s say you make $22,000 a year, receive Supplemental Nutrition Assistance Program (SNAP) benefits to help you with your grocery expenses, and get $5,000 from a family member to help with a major home repair.

This might make it seem like your income exceeds $22,590, and you wouldn’t qualify for Extra Help. But this isn’t actually the case. Medicare will not consider the amount of your SNAP benefits or the $5,000 as part of your income for the year.

In fact, many types of payment or aid you might receive in a year will not count as income when it comes to qualifying for Extra Help. This includes help or payments from federal or local government programs such as:

  • SNAP
  • housing assistance
  • home energy assistance
  • earned income tax credit payments

Medicare also will not count the money you receive in an emergency situation. Examples include:

  • disaster assistance
  • help from others to pay your household expenses
  • victim compensation payments

Additionally, Medicare does not count any scholarships or grants toward your education or a member of your household’s education. The money you received from any of these sources will not be counted as income and cannot disqualify you for Extra Help.

Are there resource limits?

The short answer is yes.

Your income and resources must fall below a certain amount to qualify for Extra Help. Resources include savings accounts, stocks, IRAs, bonds, and real estate other than your primary home.

Your home, car, and any valuables you own do not count as resources. Medicare also will not count large payments, such as a life insurance policy payout or tax refund.

To qualify in 2024, your individual resources cannot exceed $17,220. If you’re married, your combined resources must be less than $34,360.

Can you automatically qualify for Extra Help?

You can automatically qualify for Extra Help if you already receive assistance from another government program, including:

As a participant in one of these programs, you’ll still need to be enrolled in both parts of Original Medicare, but you will not need to apply separately or submit income information again. You’ll automatically qualify for the Extra Help program.

You can apply for Extra Help in a few different ways.

One of the quickest ways is to apply online. The SSA has an online application you can use to get started right away. You can also mail in your application.

If you need assistance with your application, you can:

  • apply by phone at 800-772-1213 or 800-325-0778 (TTY), calling Monday through Friday between 7 a.m. and 7 p.m.
  • apply at your local Social Security office
  • apply at your local Medicaid office, an option that’s only available if you qualify for Medicaid.

No matter how you apply, you must be prepared to give the SSA information about your finances. This can include:

  • recent pay stubs
  • bank statements, including any savings accounts
  • stock certificates or investment statements
  • information about your pension
  • recent tax returns

Once your application is approved, you’ll need to enroll in a Part D plan. Medicare considers your approval for Extra Help a qualifying event for a special enrollment period, so you do not need to wait for a standard enrollment period.

This means you can select a Part D plan once your Extra Help is approved. You can shop for Part D plans directly on the Medicare website.

You don’t need to apply separately if you’re already enrolled in Medicaid, an MSP that pays your Part B premiums, or in SSI. In these cases, you’ll be automatically enrolled in Extra Help when you join a Part D plan.

Your eligibility for Medicare Extra Help lasts for an entire year. However, Social Security will review your eligibility periodically.

To do this, the SSA will contact you with a form. These forms typically get sent out in the fall. If you don’t receive one, you can count on your Extra Help staying the same in the coming year.

If you do get a form, you’ll need to fill it out within 30 days and send it back. If you don’t, your coverage will end in January of the upcoming year. For example, if you receive an eligibility review form from Social Security on September 14, 2024, and don’t send it back by October 14, your Extra Help will end in January 2025.

When you return the form, a few things might happen. Depending on changes to your income, your Extra Help could:

  • stay the same
  • increase
  • decrease
  • end

The SSA will notify you of this decision. If you no longer qualify or qualify with higher out-of-pocket costs, you’ll get a letter explaining the changes. You might need to start paying premiums to keep your Part D plan.

Even if you no longer qualify for Extra Help, you might still be able to get help paying your Part D costs. You can contact your state’s Medicaid office or State Health Insurance Assistance Program (SHIP) for information on programs to help you pay for your prescriptions.

How do I know if I’m enrolled in Extra Help?

You’ll receive notice of your Extra Help status from the SSA. Notices are different colors depending on your status:

  • Purple notices mean you’re automatically qualified.
  • Yellow or green notices mean you’re automatically enrolled.
  • Gray notices mean you’re no longer automatically qualified.
  • Orange notices mean the amount of Extra Help you’re getting is changing.

It’s important to monitor your mail and track the notices you receive from Social Security. Reading all communication ensures you won’t be surprised by any costs and will have time to prepare for any changes.

Other programs that may help you pay for Medicare and healthcare costs

These programs can help you pay your Medicare costs:

  • Medicaid: Medicaid is a federal program that helps people with limited incomes pay their healthcare costs. It’s overseen by each state.
  • Medicare savings programs (MSPs): MSPs help people with limited income pay some of the out-of-pocket costs associated with Medicare.
  • Program of All-inclusive Care for the Elderly (PACE): PACE helps people with Medicare or Medicaid receive healthcare coverage in their communities.

Medicare Extra Help can help you afford your Part D plan.

You’ll be automatically enrolled in Extra Help if you enroll in a Part D plan and you already have SSI, Medicaid, or an MSP that pays your Part B premiums. Otherwise, you’ll need to apply with Social Security.

To qualify, you must meet specific income requirements. Once you’re approved, you can sign up for a Part D plan immediately without waiting for an enrollment window.