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How Can I Get "Extra Help" To Pay For Prescription Drugs?

Updated: Jul 29, 2021

Our staff specializes in Medicare Insurance plans. We help clients in Winchester, VA and Martinsburg, WV find the best health coverage for their situation.

If you have limited income and resources, you may qualify for help to pay for some health care and drug coverage costs. Extra Help is a program to help people with limited income and resources pay Medicare drug costs. You may qualify for Extra Help if your yearly income and resources are below these limits in 2020:

Single person:

Annual Income: less than $19,140 Other Resources: less than $14,610

Married person living with spouse:

Annual Income: less than $25,860 Other Resources: less than $29,160

These amounts may change in 2021. You may qualify even if you have a higher income (like if you still work, or have dependents living with you). Resources include money in a checking or savings account, stocks, bonds, mutual funds, and Individual Retirement Accounts (IRAs). Resources don’t include your home, car, household items, burial plot, up to $1,500 for burial expenses (per person), or life insurance policies.

If you qualify for Extra Help and join a Medicare drug plan or Medicare Advantage Plan with drug coverage, you’ll:

• Get help paying your drug coverage costs.

• Have no late enrollment penalty.

Special Enrollment Period for those who qualify for Extra Help:

If you have Medicaid or receive Extra Help, you may be able to make changes to your coverage one time during each of these periods:

• January – March

• April – June

• July – September

You automatically qualify for Extra Help if you have Medicare and meet any of these conditions: • You have full Medicaid coverage.

• You get help from your state Medicaid program paying your Part B premiums (in a Medicare Savings Program).

• You get Supplemental Security Income (SSI) benefits.

Medicare will mail you a purple letter to let you know you automatically qualify for Extra Help. Keep this for your records. You don’t need to apply for Extra Help if you get this letter. If you did not automatically qualify for Extra Help, you can apply anytime at or call social security at 800-772-1213.

Drug costs in 2021 for people who qualify are generally no more than $3.70 for each generic drug and $9.20 for each brand-name drug.

Different plans cover different drugs. There are many plans to choose from. Contact your Medicare Insurance Agent to help you find the best plan that provides best coverage for the prescriptions you take.


As Independent Insurance Brokers, we are appointed by many of the major insurance carriers that offer Medicare policies in Virginia and West Virginia. We can help you sign up for Medicare and find the best Insurance policy for your individual situation.Contact us today at (540) 662-4432 to speak with one of our agents or visit our website to obtain more information.

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