What is "Extra Help"?

If you have a Prescription Drug Plan (PDP) or have heard anything about them, perhaps you've heard the phrase "Extra Help".  You might be wondering, what is it, who is it for, and how do I get it?  Good questions! 

Extra Help is a program administered by the Social Security Administration (SSA) that provides assistance to Medicare beneficiaries to help with the cost of their prescription drugs.  If awarded, Extra Help can provide assistance in the following ways.

• Premium.  Extra Help can lower or completely eliminate your premium based on your income level and/or the PDP you're enrolled in.
• Deductible.  If your PDP has a deductible, Extra Help can lower or completely eliminate your annual deductible depending on your income level.
• Drug Copays.  Extra Help can lower your drug copays.  The base benefit lowers your copays to a flat 15%, while the most generous benefit reduces your copays to two fixed amounts - $2.60 for generics and $6.50 for brand name drugs.  The level of benefit depends on your income level.

Extra Help is available to any Medicare beneficiary that meets certain criteria.  The two prime criteria are income level and resources.  To receive benefits, a single person needs to have an annual income of less than $16,755.  For married persons the limit is $22,695.  The resource limit to receive benefits is $13,070 for a single person, or $26,120 for a married couple.  Not all assets, however, count as resources.  For example, the value of your primary residence, your car, or any life insurance you may carry does not count towards the resource total.  Click here for more information on what is classified as a resource.

There are three ways to apply for Extra Help.

• Online.  Click here to be directed to the SSA website to begin an application.
• By Phone.  You can call 800-772-1213 (or 800-325-0778 for TTY users) and submit an application over the phone.
• Social Security Office.  You can also stop by a local Social Security office and apply in person.  To find the office nearest you click here.

For more detailed information on the Extra Help program, you can visit the Extra Help page on SSA's website:  http://ssa.gov/prescriptionhelp/index.htm.