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What is "Extra Help" and how could it save you money on prescriptions?

Updated: Apr 25


Man at pharmacy

Many of you are eligible for Extra Help and may not even know it. For this Blog we are going to talk about Extra Help and what it provides to you as a Medicare Beneficiary.


Who is eligible for Extra Help?

You automatically qualify for Extra Help if you have:

  • Both Medicare and Medicaid

  • Help from Medicaid paying your Medicare Part B premium

  • You have both Medicare and Supplemental Security Income (SSI)

What will Extra Help do for you, the Beneficiary?

  • Extra Help will lower your monthly drug co-pays considerably and, in some instances, pay 100% of your drug copays. For 2022 you should pay no more than $3.95 for generic drugs and $9.85 for brand-name drugs.

  • Your Medicare Part D drug premium is usually $0 monthly and you will have no drug deductibles.

  • Extra Help is worth about $5,100 per year in savings.

When can I apply for Extra Help?

  • You can apply anytime, there is no Annual Enrollment Period or Special Enrollment Period.

  • The best time is right after you receive your Medicare card.

Where do I apply for Extra Help?

  • Apply through your local Medicaid Office or through Medicare

  • An agent/broker that helps with Medicaid and Extra Help

  • A Medicaid Assistance Company

Perfiniti Tip

Our sister company The WellFund will help you apply for Extra Help at no charge to you. Please call (855) 365-9300 or visit https://www.thewellfund.org/contact


How do I qualify for Extra Help?

  • You make less than $1,720.00 up to $2,116.00 (Single) or $2,309.00 up to $2,843.00 (Married) per month.

  • Your assets do not amount to more than $8,400.00 (Single) and $12,600.00 (Married). Assets would include extra cars (you are allowed one without it being counted as assets), large amounts in your bank account, 401K, Whole Life Insurance.

  • If you are receiving SSI benefits, you are automatically qualified for Extra Help.



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