If you have limited income and resources, you may qualify for extra help with the costs for your prescription drug coverage. The amount of extra help depends on your income and resources. If you qualify, your copayments may be less.
How does the extra help from Medicare affect what I pay for prescription drugs?
If you qualify for extra help, your costs for prescription drugs will be one of the following, depending on the amount of extra help for which you qualify:
- $0 for generics and brands that are treated as generics; $0.00 for brand name drugs
- $1.10 for generics and brands that are treated as generics; $3.30 for brand name drugs
- $2.50 for generics and brands that are treated as generics; $6.30 for brand name drugs
- 15% co-insurance for all drugs
In addition, there is no “coverage gap” for people who qualify for extra help.
How do I find out if I qualify?
To see if you qualify for getting extra help, call:
- 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week. TTY/TDD users should call 1-877-486-2048
- The Social Security Administration at 1-800-772-1213 between
7 a.m. and 7 p.m., Monday – Friday. TTY/TDD users should call
- Your state health insurance program
If you are already getting extra help, you may receive (or may have received) a letter from Medicare or the Social Security Administration (SSA) about your eligibility for extra help. Read this important information carefully.
If you don’t know what level of extra help you qualify for, you can call
1-800-MEDICARE (1-800-633-4227) for this information. TTY/TDD users should call 1-877-486-2048. They are available 24 hours a day, 7 days a week.