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Application Help

The Medicare Prescription Drug program (also known as Part D) gives you a choice of prescription plans that offer various types of coverage. Depending on your income and resources, you may be able to get help paying for your monthly premiums, annual deductible, and the cost of medications covered by your plan, providing you an average value of $4,000 per year. However, to get this help, you must be enrolled in a Medicare Prescription Drug plan.

Information About This Application

Follow the link below for specific information regarding this application:

How The Online Application Works

What Is This Application?

This is an application for Extra Help with Medicare prescription drug costs. It does not enroll you in a Medicare prescription drug plan. To get that coverage, you will have to enroll directly with an approved Medicare prescription drug plan. If you need information about Medicare Prescription Drug plans or how to enroll in a plan, call Medicare's toll-free number 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048) or visit

You also may be able to get help from your State with other Medicare costs under the Medicare Savings Programs. By completing this online application for Extra Help, you will start the application process for a Medicare Savings Program. SSA will send information from your Extra Help application to your State, unless you tell SSA not to when you complete this form. Someone from your State will contact you to help you complete your Medicare Savings Program application.

How Can You Get The Extra Help?

To get Extra Help with Medicare prescription drug costs, you must complete and submit this application. The Social Security Administration (SSA) will review your application and send you a letter to let you know if you qualify for Extra Help. SSA will also send you information about the Medicare Prescription Drug Coverage and tell you what you should do next.

NOTE: To apply, you must live in one of the 50 States or the District of Columbia.

If you need help completing this application, click here to find a local agency in your community, or call Social Security toll-free at 1-800-772-1213 (TTY 1-800-325-0778).

If you need information about Medicare Savings Programs, the Medicare Prescription Drug Program or how to enroll in a plan, call Medicare's toll-free number 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048) or visit

Who Should Complete This Application For Extra Help With Costs under the Medicare Prescription Drug Coverage?

You should complete this online application for Extra Help if:
  • You have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Supplementary Medical Insurance); and
  • You live in one of the 50 states or the District of Columbia; and
  • Your income is below $18,210 if you are not currently married or not living with your spouse, or $24,690 if you are currently married or living with your spouse; and
  • Your combined savings, investments, and real estate (other than the home you live in) are not worth more than $14,100 if you are not currently married or not living with your spouse, or $28,150 if you are married and living with your spouse. (DO NOT include the home you live in, vehicles, personal possessions, life insurance, burial plots, irrevocable burial contracts or back payments from Social Security or SSI.)
Depending on your situation, you may still be eligible for this Extra Help even if you have more than those amounts. If there is any doubt about the amounts, or you need a letter stating that you are not eligible, complete and submit the application. But even if you do not qualify for the Extra Help, you can still enroll in a Medicare prescription drug plan so that you can get coverage for your prescriptions.

Who Should Not Complete This Application For Extra Help With The Medicare Prescription Drug Plan Costs?

You should not complete this online application if:
  • You receive Medicaid and have Medicare, or
  • Your State pays for your Medicare premiums (you are enrolled in one of the Medicare Savings Programs), or
  • You receive Supplemental Security Income (SSI) payments and have Medicare.
If you are in one of the 3 groups above, you will automatically get the Extra Help and do not need to apply. You will be contacted about the Extra Help and what you need to do next.

What Information Will You Need?

To find out if you could be eligible for Extra Help with Medicare prescription drug costs, Social Security needs information about your (and your spouse's, if you are married and living together) income and resources. Documents that may help you prepare include:
  • Social Security card;
  • bank account statements, including checking, savings, and certificates of deposit (CDs);
  • Individual Retirement Accounts (IRAs), stocks, bonds, savings bonds, mutual funds, other investment statements;
  • tax returns;
  • payroll slips; and
  • your most recent Social Security benefits award letters or statements for Railroad Retirement benefits, Veterans benefits, pensions and annuities.
If you do not have these documents, provide us with your best estimate so that Social Security can tell you whether you are likely to qualify for Extra Help with your Medicare prescription drug costs. You only need this information to help you complete the application. You should not have to submit the documents unless someone from Social Security contacts you.

What If You Need To Stop And Come Back Later?

This application should be completed in one session because you will not be able to save an incomplete application.

Can You Edit Your Information?

When you have completed the application, you will get a full summary of the information you entered. You can make changes if necessary before you submit your application. After you submit the application electronically, you will be able to print or save a receipt for your submitted application.

How Long Can You Work On Each Page?

For security reasons, there are time limits for your work on each page. After 45 minutes on a page, you must go to another page or your application session will end, and your work will be lost.

Are There Other Ways To Apply?

If you prefer not to fill out this application on the Internet, you can call the Social Security Administration's toll-free number, 1-800-772-1213 (TTY 1-800-325-0778) for a paper application. You can also visit your local Social Security office. Staff are available Monday through Friday from 7 a.m. to 7 p.m. (All Time Zones). Tell the staff person you speak with that you want to apply for help with Medicare prescription drug costs.

Information About Medicare

Follow the links below for more specific information regarding the Prescription Drug Program and Medicare:

About The Prescription Drug Program

Medicare Information:

Official U.S. Government Medicare Site

Centers for Medicare & Medicaid Services

Legal And Official Information

Internet Security Policy