Unfortunately, some people lost their Medicare Part D Extra Help benefits when their Social Security benefit increase pushed them above the Extra Help financial limits.  But these people are urged to re-apply for Extra Help now based on the 2025 Extra Help qualification limits.

As a reminder, Medicare Part D Extra Help is a government program that helps low-income people pay all or part of their monthly Medicare Part D drug plan premiums, deductible, and may cover a significant portion of their prescription drug costs.

If you are having difficulties this year paying for your prescriptions, you may want to learn more about the Medicare Part D Extra Help program by calling the Social Security Administration at 1-800-772-1213 or your local state Medicaid office. 

If you qualify for Medicaid, you automatically qualify for Extra Help.

However, even if you do not meet the financial qualifications for Medicaid, you may still qualify for at least partial benefits from the Medicare Part D Extra Help program based on your annual income and financial resources.

You can click here to learn more about qualifying for the Medicare Part D Extra Help program.

As in past years, if your financial status changes during the year – in other words, your income and resources fall below the Extra Help limits, you may qualify at that point for Extra Help, and you will continue to receive Extra Help assistance with your Medicare Part D plan premiums and prescription costs for the remainder of the year, even if your income or resources were to rise above the established Extra Help limits later in the year.

Typically, the Extra Help application uses the most recent tax return information sent to Social Security from the IRS.  However, if you have had significant changes in your income in comparison to your most-recent tax return, you can appeal to Social Security to use more recent income figures.  Please see: How to appeal the decision Social Security made on your application for Extra Help.

Also, we want to remind our readers about the Medicaid “Spend-Down” program.  If permitted by your state, Medicaid “Spenddown” allows you to subtract your medical expenses (like what you pay for your prescription medications) from your annual income so that you might become eligible for your state’s Medicaid program.

In other words, you may be eligible for your state’s Medicaid program based on the principle of “Spend-Down”, even if you would otherwise earn too much to qualify for Medicaid.  You can click here to read more about Medicaid Spend Down.