Save on drug costs

If you meet certain income and resource limits, you may qualify for Extra Help from Medicare to pay the costs of Medicare prescription drug coverage.

Drug costs in 2012 for most people who qualify will be no more than $2.60 for each generic/$6.50 for each brand-name covered drugs.

Other people pay only a portion of their Medicare drug plan premiums and deductibles based on their income level.

You may qualify if you have up to $16,755 in yearly income ($22,695 for a married couple) and up to $13,070 in resources ($26,120 for a married couple). 

If you don't qualify for Extra Help, your state may have programs that can help pay your prescription drug costs. Contact your State Medical Assistance (Medicaid) office or your State Health Insurance Assistance Program (SHIP) for more information. Remember, you can reapply for Extra Help at any time if your income and resources change.

Countable resources include:

  • Money in a checking or savings account
  • Stocks
  • Bonds

Countable resources don't include:

  • Your home
  • One car
  • Burial plot
  • Up to $1,500 for burial expenses if you have put that money aside
  • Furniture
  • Other household and personal items

Apply for Extra Help.

Some people automatically qualify for Extra Help

You automatically qualify for Extra Help if you have Medicare and meet any of these conditions:

  • Have full Medicaid coverage
  • Get help from your state Medicaid program paying your Part B premiums (in a Medicare Savings Program)
  • Get Supplemental Security Income (SSI) benefits.

Even if you automatically qualify this year, you may not next year if your income or resources change. If you no longer automatically qualify, you’ll get a notice (on grey paper) by the end of September. Even if you get this notice, you may still qualify, but you need to apply to find out.

  • If your copayment amounts change for 2013, you'll get a notice (on orange paper) in the mail in early October with the new amounts.
  • If you don't get a notice from Medicare, you'll get the same level of Extra Help that you got for last year.
Note

These amounts may change in 2013.

Paying the right amount

If you’re not sure if you're paying the right amount, call your drug plan. Your plan may ask you to give information to help them check your level of Extra Help you should get.

Can I get money back if I've been paying too much?

If you aren't already enrolled in a Medicare drug plan and paid for prescriptions since you qualified for Extra Help, you may be able to get back part of what you paid. Keep your receipts and call your plan or you can contact: Medicare's Limited Income Newly Eligible Transition (NET) Program at 1-800-783-1307 for more information. TTY users should call 1-877-801-0369.

Other ways to lower your prescription drug costs