Help with Medicare Costs
Extra help with Medicare prescription drug plan costs
What is Medicare Extra Help?
If you have limited income and resources, you may qualify for Extra Help to assist in paying for your Part D drugs. Many people qualify for this Medicare program and don’t even know it. It helps pay some costs, such as these:
- Plan premiums
- Prescription deductibles
- Copays
- Coinsurance
Who qualifies for Extra Help with Medicare Drug costs?
To qualify for Extra Help you must be enrolled in a Part D prescription drug plan, live in one of the 50 states or the District of Columbia, and meet certain income and resource guidelines. Medicare members with Supplemental Security Income (SSI) or Medicare and Medicaid will automatically receive Extra Help.
In 2026, most people qualify if their yearly individual income is $23,940 or less, or $32,460 or less for married couples, and their resources are $18,090 or less for individuals or $36,100 or less for married couples. Resources include things like stocks, bonds, or money in a checking, savings, or retirement account. Your home, car, burial plots, and personal belongings do not count toward your resource limit. These limits may go up each year, and you can reapply if your situation changes.
Some people automatically get Extra Help if they already receive full Medicaid coverage, Supplement Security Income (SSI) payments from Social Security, or help paying Part B premiums through a Medicare Savings Program.
To see if you qualify for Extra Help:
Call 1-800-MEDICARE
1-800-633-4227 (TTY: 1-877-486-2048)
24 hours a day, 7 days a week, or visit medicare.gov.
Call Social Security
1-800-772-1213 (TTY: 1-800-325-0778)
weekdays from 8 a.m. to 7 p.m.
Apply on the Social Security website.
PACE and PACENET
Pennsylvania has two prescription assistance programs for older adults. PACE and PACENET offer low-cost prescription medication to qualified residents age 65 and older.
To see if you qualify for PACE or PACENET:
Call the Pennsylvania Department of Aging at 1-800-225-7223 (TTY: 1-800-222-9004) weekdays from 8:30 a.m. to 5 p.m., or enroll online at pacecares.primetherapeutics.com.
Medicaid
Medical Assistance (Medicaid) provides health coverage to millions of low-income individuals. It is administered by states according to federal requirements and is funded by states and the federal government together to make sure everyone can get the care they need. Medicaid is designed to cover almost all costs for those who need it most.
To see if you qualify for Medical Assistance (Medicaid):
Call Medical Assistance at 1-800-692-7462 (TTY: 1-800-451-5886) Monday through Friday from 8:30 a.m. to 5 p.m., or visit dhs.pa.gov.
Veterans Affairs benefits
If you have served in the armed forces, you may have additional benefits provided to you by the Department of Veterans Affairs (VA).
To see if you qualify for VA benefits:
Go to your local VA facility or apply online at VA.gov.
Frequently asked questions about Extra Help
What is the income limit for Extra Help in 2026?
Do I need to reapply for Extra Help each year?
No, you do not need to reapply every year. Social Security will review your eligibility automatically and notify you if anything changes or if you no longer qualify. If you are not contacted and continue to meet the requirements, your Extra Help will continue.
Can I apply for Extra Help if I don’t have Medicaid?
Yes, you can still apply for Extra Help if you don’t have Medicaid. Many people qualify based on income and resources alone. You may also automatically qualify without applying if you already receive Medicaid, Supplemental Security Income (SSI), or assistance from a Medicare Savings Program.
Does Extra Help cover all prescription drugs?
Extra Help makes prescription drug costs more affordable, but you still need to be enrolled in a Medicare Part D drug plan or a Medicare Advantage plan with drug coverage. It helps pay for premiums, deductibles, coinsurance, and copays, but you should still check that your specific medications are covered by your plan.
What happens if my income changes?
If your income or resources change, you may still qualify or begin to qualify for Extra Help. You can apply or reapply any time your financial situation changes. Social Security will review your updated information and determine if you are still eligible or become eligible.
Medicare resources
View MoreThis information is not a complete description of benefits. Call 1-866-400-5077 (TTY: 711) for more information. Out-of-network/Noncontracted providers are under no obligation to treat UPMC for Life members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services. Other physicians/providers are available in the UPMC for Life network.
This information is available for free in other languages. Please call our customer service number at 1-877-539-3080 (TTY: 711).
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