Reviewed for accuracy by Lauri Middleton, RN, MSN, licensed Medicare agentReviewed for clarity by Karen OrillaMeet our reviewers →
Extra Help is a Medicare program for people with limited income that pays most of the Part D premium and deductible and caps each prescription at a low copay. You apply through Social Security online or by phone; a HICAP counselor will do it with you for free. If you are in a Medicare Savings Program or Medi-Cal, you get Extra Help automatically. Pharmacists often spot people who qualify — it is worth asking.
Apply this to my situationThe rules behind this
Extra Help lowers what you pay for prescriptions
Extra Help is a Medicare program that pays most of the Part D premium and deductible and caps what you pay for each prescription at a low amount. You apply through Social Security; people in a Medicare Savings Program or Medi-Cal get it automatically.
Who this is for
People with Medicare drug coverage and limited income and resources.
What changes it
- You still need to be in a Medicare drug plan; Extra Help lowers its cost rather than replacing it.
The question that settles it
“Can I apply for Extra Help, and which drug plans work best with it in my county?” — Social Security (apply) and HICAP (plan help).
Medicare Savings Programs can pay your Part B premium — and sometimes much more
There are levels. QMB pays Part A and Part B premiums, deductibles, coinsurance and copays, and providers may not bill you for Medicare-covered services. SLMB and QI pay the Part B premium. Which level applies depends on income limits set each year. Qualifying for any level also automatically qualifies you for Extra Help with drug costs.
Who this is for
People with Medicare and limited income.
What changes it
- Income limits change every year; the agency, not this site, decides.
The question that settles it
“Which Medicare Savings Program level might I qualify for, and will you help me apply?” — California HICAP or your county Medi-Cal office.
Get help
Free Medicare counseling
California HICAP offers free, confidential Medicare counseling. Ask the local program about language and appointment availability.
California HICAP1-800-MEDICARE
Call 1-800-MEDICARE and ask for an interpreter. TTY: 1-877-486-2048.
Call Medicare · 1-800-633-4227Official information in other languages ↗External resource. Some pages are in English; ask for language assistance if needed.