SSA logo: link to Social Security Online home2601. Eligibility for Extra Help with Prescription Drug Costs

2601.1 When are you entitled to Extra Help with Prescription Drug Costs?

You are entitled to Extra Help with prescription drug costs if you:

  1. Are entitled to benefits under Medicare Part A (hospital insurance) or enrolled in Medicare Part B (medical insurance) or both, and

  2. Reside in one of the 50 states or the District of Columbia, and

  3. Have countable resources of less than $12,640 if you are single and $25,260 if you are married and living together (in 2011),

    NOTE: Resources do not include your home, car, household items, burial plot, $1,500 per person for burial expenses, or life insurance policies, and

  4. Have an annual income of less than $16,335 if you are single or $22,065 if you are married and living together (in 2011). Your income can be higher if you support other family members who live with you, have earnings from work, or live in Alaska or Hawaii, and

  5. File an application with SSA or with a Medicaid State agency.

2601.2 How do I apply for this Extra Help?

You may apply online at: http://www.socialsecurity.gov, at a local Social Security office, or with your State Medicaid Agency. You may also receive an application in the mail. It should be completed and mailed to the Social Security Administration, Wilkes-Barre Data Operations Center, P.O. Box 1020, Wilkes-Barre, PA 18767-9910.

2601.3 When Is It NOT Necessary to File an Application?

You do not need to file an application if you:

  • receive Supplemental Security Income (SSI) payments and have Medicare, or

  • you have full Medicaid and Medicare coverage.

If your State Medicaid program pays your Medicare Part B premiums because you belong to a Medicare Savings Program, contact your State whether you should file an application for Extra Help. You may be able to get this coverage automatically.

Last Revised: Aug. 10, 2011