Prescription drugs may treat or cure health problems, but all too often, they lead to financial problems. Many don't come cheap, and you usually have no choice but to pay for them. Insurance may help a little, and you might be able to find online coupons to knock down some of the cost. But that's not always enough.
Fortunately for seniors, there's a program that could cap prescription drug costs at $4.50 for each generic drug refill and $11.20 for each name-brand drug refill in 2024. Here's what you need to know.
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Extra Help for those in need
Medicare's Extra Help program is available to low-income seniors who need assistance paying for their prescription drug costs. It caps the per-drug price at the limits mentioned above, and should your prescription drug costs exceed $8,000 for the year, you won't pay a dime for your prescriptions for the rest of 2024.
Some people qualify for Extra Help automatically, including those who:
- Receive full Medicaid coverage
- Receive help from their state paying Medicare Part B premiums
- Receive Supplemental Security Income (SSI) benefits
Medicare automatically enrolls these individuals in Extra Help and a Medicare Part D plan. If you do nothing, you'll remain on the plan Medicare has assigned to you in 2024. But you can also choose your own Part D plan before the open enrollment period ends on Dec. 7, 2023.
If you don't meet one of the criteria listed above, you may still be eligible for the Extra Help program. But you'll need to apply on your own.
How to apply for Extra Help
Eligibility for Extra Help depends on your income and resources. Here's a table showing the limits for 2023. The limits for 2024 haven't been announced yet, but they may be slightly higher.
|
Marital Status |
Maximum Income to Be Eligible |
Maximum Resources to Be Eligible |
|---|---|---|
|
Individual |
$21,870 |
$16,600 |
|
Married |
$29,580 |
$33,240 |
Source: Medicare.gov.
A few notes: Resources are considered money you have in bank accounts, stocks, and bonds. The following are not counted as part of your resources:
- Your home
- One car
- Burial plot
- Up to $1,500 for burial expenses
- Furniture
- Other household or personal items
Also, those residing in Alaska or Hawaii may be able to qualify for Extra Help with higher income and resource limits due to the higher cost of living in these states.
If you believe you might qualify, you can apply for Extra Help on the Social Security Administration website. To do this, you must live in one of the 50 states or the District of Columbia.
After you've submitted your application, the government will review it to determine if you're eligible for Extra Help. Once it's reached its answer, it will send you a letter informing you of the decision. It will also provide the details for the Part D plan it automatically enrolled you in if you're approved.
Once you're approved for Extra Help, you'll receive it through the end of the calendar year. If you continue to meet the income and resource requirements in the following year, you can remain in the program. If your Part D plan changes or you are no longer eligible for the program, you'll receive a letter from Medicare explaining this.
If you take prescription drugs regularly and think you could benefit from Extra Help, apply right away. There's not much time left in the open enrollment period for the year, and it can take some time for the government to review your application. The sooner you're approved, the sooner you can begin saving on your retirement healthcare costs.
