Saving On Part-D Drug Costs

Drugs can represent significant out-of-pocket costs for those eligible for Medicare, but there is help. If you meet certain income and resource limits, you may qualify for Extra Help from Medicare to pay the costs of Medicare prescription drug coverage. In 2017, costs are no more than $3.30 for each generic/$8.25 for each brand-name covered drug. Some people may pay only a portion of their Medicare drug plan premiums and deductibles based on their income level.  In 2017, you may qualify if you have up to $18,090 in yearly income ($24,360 for a married couple) and up to $13,820 in resources ($27,600 for a married couple).

Countable resources include:

  • Money in a checking or savings account
  • Stocks
  • Bonds

Countable resources don’t include:

  • Your home
  • One car
  • Burial plot
  • Up to $1,500 for burial expenses if you have put that money aside
  • Furniture
  • Other household and personal items

Apply for Extra Help here.

You automatically qualify for Extra Help if you have Medicare and meet any of these conditions:

  • Have full Medicaid coverage
  • Get help from your state Medicaid program paying your Part B premiums (in a Medicare Savings Programs)
  • Get Supplemental Security Income (SSI) benefits

Even if you automatically qualify this year, you may not qualify for Extra Help next year. Changes in your income or resources may cause you no longer to qualify for one of the programs listed above. You’ll get a notice (on grey paper) by the end of September if you no longer automatically qualify. Even if you get this notice, you may still qualify, but you need to apply to find out. If your copayment amounts change for 2018, you’ll get a notice (on orange paper) in the mail in early October with the new amounts. If you don’t get a notice from Medicare, you’ll get the same level of Extra Help that you got for last year.

Other ways to save on drug costs:

Many states and the U.S. Virgin Islands offer help paying drug plan premiums and/or other drug costs. Click here to see if there are any programs are available in your area .

Some pharmaceutical companies also offer assistance programs for specific drugs they manufacture. You can search here  to identify programs available for specific drugs.


You may also qualify for a Medicare Advantage Special Enrollment Period (SEP):

  • If you qualify for Extra Help paying for Medicare prescription drug coverage you can join, switch, or drop Medicare prescription drug coverage anytime. Your coverage will begin the first day of the month after you qualify for Extra Help and ask to join a plan.
  • If you are enrolled in a State Pharmaceutical Assistance Program (SPAP) or lose SPAP eligibility you can join either a Medicare Prescription Drug Plan or a Medicare Advantage Plan with prescription drug coverage once during the calendar year.