Get Help Paying Your Medicare Costs

Extra Help

Extra Help is a Medicare program to help people with limited income and resources pay Medicare prescription drug premiums, deductibles, copayments, and coinsurance costs. You also won’t have to pay a Part D late enrollment penalty while you receive Extra Help.

To qualify for Extra Help, you must have income and resources below certain limits. You can find the current income and resource limits here. These limits may go up each year.

Income is the money you and your spouse (if you’re married) earn in a calendar year. 

Resources are assets you own, such as money in a checking or savings account, stocks, bonds, mutual funds, and Individual Retirement Accounts (IRAs). Resources do not include your home, car, household items, burial plot, up to $1,500 per person for burial expenses, or life insurance policies.

Who Automatically gets Extra Help?

You’ll get Extra Help automatically if:

• You have full Medicaid coverage.
• You get help from your state Medicaid program paying your Part B premiums (through a Medicare Savings Program).
• You get Supplemental Security Income (SSI) benefits.

How to Apply for Extra Help?

• Visit Social Security to apply online.
• Call the Social Security Administration at 1-800-772-1213. TTY users can call 1-800-325-0778.
• Call SHIIP at 1-855-408-1212.

Medicare Savings Programs

A Medicare Savings Program (MSP) is a state-administered Medicaid program that helps people with limited income and resources pay for their out-of-pocket Medicare costs, such as premiums, deductibles, coinsurance, and copayments. MSP eligibility is income-based, and guidelines may vary from state to state. 

There are four kinds of Medicare Savings Programs:

• Qualified Medicare Beneficiary (QMB) Program - helps pay for Part A and/or Part B premiums, and in addition Medicare providers aren't allowed to bill you for services and items Medicare covers like deductibles, coinsurance, and copayments.
• Specified Low-Income Medicare Beneficiary (SLMB) Program - helps pay for Part B premiums.
• Qualified Individual (QI) Program - helps pay for Part B premiums and funding for this program is limited.
• Qualified Disabled and Working Individuals (QDWI) Program - helps pay for Part A premiums only.

If you qualify for a QMB, SLMB, or QI program, you automatically qualify for Extra Help. 

You can apply for a North Carolina MSP through NC Medicaid online or through your county Department of Social Services.

Supplemental Security Income

Supplemental Security Income (SSI) is a monthly cash benefit from Social Security for people who have limited income and resources and are blind, age 65 or older, or have a disability.

SSI is different from Social Security retirement benefits. You may qualify for both SSI and Social Security benefits if your Social Security benefit is low enough, which may be the case if you have a limited work history, a history of low-wage work, or both.

If you qualify for SSI, you automatically qualify for Extra Help.

State Pharmacy Assistance Programs

Many states have State Pharmacy Assistance Programs that help certain people pay for prescription drugs based on financial need, age, or medical condition.

Pharmaceutical Assistance Programs

Some pharmaceutical companies offer Patient Assistance Programs to help pay for prescriptions for people in a Medicare Part D plan.