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A new survey from the National Council on Aging and the Women's Institute for a Secure Retirement found that about 1 in 5 women nearing or in retirement delayed filling a prescription in the past year because of cost, and roughly 1 in 3 went without some form of health care or food. If a refill is starting to feel optional, you're not the only one making that call, and there's a real program built for exactly this situation that most eligible people never apply for.
It's called Extra Help. It's a federal program that lowers what you pay for Medicare Part D drug coverage, premiums, deductibles, and the price at the counter, for people with limited income and resources. Some people get it automatically. Everyone else has to apply, and the application is shorter than most people expect.
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Most people in this situation haven't applied yet, even when they'd likely qualify.
Interactive toolLog what you're already cutting back onKeep a running list of any medication you've skipped, delayed, or split to save money. It's useful if you apply for Extra Help or talk to a pharmacist about I don't know if I qualify.Show the toolHide the tool
Track medication changes and side effects between visits in one downloadable list.
What Extra Help actually pays for
If you qualify, Extra Help brings your Part D premium and deductible to $0 and caps what you pay per prescription at your plan's participating pharmacies: up to $5.10 for a generic drug and up to $12.65 for a brand-name drug in 2026. Once your total drug costs for the year reach $2,100, including amounts paid on your behalf through the program, your covered drugs cost $0 for the rest of the year. If you also have full Medicaid coverage and are in the Qualified Medicare Beneficiary program, that per-drug cap drops to $4.90.
You also stop owing the Part D late enrollment penalty for as long as you receive Extra Help, which matters if you delayed enrolling in a drug plan because the premium didn't fit your budget at the time.
ChecklistCheck your 2026 numbers before you assume either wayThese are the limits for 2026. They typically rise slightly each year, so check the current figures if you're reading this later.Show the checklistHide the checklist
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Who gets it automatically, and who has to apply
You qualify for Extra Help automatically, with no separate application, if you already have full Medicaid coverage, get help from your state paying your Medicare Part B premium through a Medicare Savings Program, or receive Supplemental Security Income (SSI) payments. Social Security mails a notice once that automatic enrollment happens.
Everyone else has to apply, and a lot of people who'd qualify never do, often because they assume a program with income limits this specific must not apply to them, or because the paperwork sounds more complicated than it is. If you're on Medicaid or Medicare together already, Medicare and Medicaid Together: How Dual Eligibility Actually Works covers how those two programs coordinate, including how Extra Help fits in.
ChecklistConfirm whether you already qualify automaticallyIf any of these are true, you may already have Extra Help and not know it.Show the checklistHide the checklist
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Apply before you cut a pill in half
Don't change how you take a medication to stretch it further without your doctor's sign-off first. Some prescriptions lose effectiveness or become unsafe when the dose is inconsistent. Applying for Extra Help, or getting immediate help through a patient assistance program while you wait, is the safer move.
If the cost problem is with one specific medication rather than your overall drug coverage, Generic Drug Prices Are Rising. Do This Before You Pay Full Price covers pharmacy price comparisons and manufacturer assistance programs that can help sooner than an Extra Help application processes.
TimelineApply for Extra Help in orderCheck off each step as you complete it.Show the timelineHide the timeline
Confirm whether I don't know if I qualify already qualifies you without an application.
Apply online, by phone, or in person through Social Security, or call your local State Health Insurance Assistance Program (SHIP) for free help completing it.
Social Security or Medicare will mail a notice with your Extra Help level and any plan change. Keep it with your records.
You can apply again anytime your income or resources change, even in the same year.
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Save what you found here so you have it ready when you apply or call Social Security.
Common questions
What is Medicare Extra Help?
Extra Help is a federal program that lowers what you pay for Medicare Part D drug coverage if you have limited income and resources. It can bring your premium and deductible to $0 and cap what you pay per prescription, with 2026 limits of up to $5.10 for a generic drug and up to $12.65 for a brand-name drug.
Who qualifies for Extra Help automatically?
You qualify automatically, with no separate application, if you have full Medicaid coverage, get help from your state paying your Medicare Part B premium through a Medicare Savings Program, or receive Supplemental Security Income (SSI) payments. Social Security mails a notice once automatic enrollment happens.
What are the income and resource limits for Extra Help in 2026?
For an individual, the 2026 limits are income under $23,940 and resources under $18,090. For a married couple, the limits are income under $32,460 and resources under $36,100. Resources generally count savings, stocks, and bonds, not your home or car.
Is it safe to skip a prescription dose to save money?
Not without your doctor's sign-off. Some medications lose effectiveness or become unsafe when the dose is inconsistent. Applying for Extra Help, or using a manufacturer or nonprofit patient assistance program while an application processes, is the safer way to lower the cost.
