I'm a low-income senior who can't afford my prescription drugs even with Medicare Part D. What specific assistance programs should I apply for?

Question

Mark Cunningham · Accepted Answer

As a low-income senior, it can be challenging to afford prescription drugs, even with Medicare Part D. However, various assistance programs are available to help alleviate this burden. This document provides a comprehensive guide to specific assistance programs you can apply for to receive the help you need.
1. Extra Help from Medicare
To qualify for Extra Help, you must:
•	Be enrolled in Medicare Part D
•	Have an income below 150% of the federal poverty level
•	Have limited financial resources
How to Apply
You can apply for Extra Help through the Social Security Administration (SSA) website, by calling SSA, or by visiting your local SSA office.
2. State Pharmaceutical Assistance Programs (SPAPs)
Eligibility requirements for SPAPs differ depending on the state, but they generally include:
•	Residency in the state
•	Enrollment in Medicare Part D
•	Meeting specific income and resource limits
How to Apply
To find out if your state has a SPAP and how to apply, visit the Medicare website or contact your state's Department of Health Services. - https://www.medicare.gov/basics/costs/help/drug-costs
3. Pharmaceutical Company Patient Assistance Programs (PAPs)
Each pharmaceutical company has its own eligibility requirements, but they generally include:
•	Having no insurance coverage or limited coverage for the medication
•	Meeting specific income limits
4. Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including prescription drugs.
Eligibility Criteria
Eligibility for Medicaid varies by state, but typically includes:
•	Having a low income
•	Meeting specific resource limits
How to Apply
To apply for Medicaid, contact your state’s Medicaid office or visit their website.

Larry Dalton · Answer

There is assistance to help those with difficulty meeting their financial needs. I advise seeking extra help through the Low-Income Subsidy (LIS) and Medicare Savings programs. Although these programs may not cover one hundred percent of your drug costs, they can help offset expenses. You can also check with the State Pharmaceutical Assistance Program, known as SPAP, in Oklahoma or Texas, which offers additional help with drug costs. To sign up for your LIS, low-income subsidy program, I recommend seeking assistance at the Department of Human Services, which manages the state Medicaid programs. You can also apply through the Social Security Administration. If you are on Medicaid or SSI when you sign up for Medicare, you will automatically be enrolled in this Medicare Savings Program.

Answered by Larry Dalton on May 2, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent

Tony Capraro III · Answer

I'd refer you to:  Medicare.gov    Those folks are wonderful and know how to guide and help folks!

Tasha Riggs · Answer

You should go to www.SSA.Gov and apply for part D Extra Help program. 
You will need bank statements and tax return information and any retirement benefits to see if you qualify. If you want to talk to someone at Social Security the number you can call is :
1-800-772-1213
You can even look at Medicare.Gov and research Medicare part D extra help. I would also consider looking at LIS : Limited income subsidy. It may help with copays and premiums

Danny Radisewitz · Answer

I loved the short answer to this question Apply for LIS/Extra Help! Its easy to do, it doesn't take long and if you are not eligible "NO BIG DEAL"! You don't need to go to any government office and set a future appointment. Just APPLY! You won't regret it!

Answered by Danny Radisewitz on April 7, 2025

Broker Licensed in SD, IA, MN & ND

Answered by Danny Radisewitz Medicare Insurance Agent

Angela Ellington · Answer

The first thing that I recommend is applying for Extra Help through Social Security. If you do not qualify for that program, you may save by using GoodRx or Optum Perks which offer coupons that may be more affordable than using your Part D coverage. I have also referred some of my clients to fill certain prescription from the Canadian Med Store. Lastly, Part D has a catastrophic limit of $2000 in 2025 and they have started a payment plan that's called M3P that's spreads your copays out through the rest of the year in the event that a drug costs more than $600 to fill due to the deductible or coinsurance having a high cost up front.

Answered by Angela Ellington on April 21, 2025

Agent Licensed in CA, AZ, FL & 9 other states

Answered by Angela Ellington Medicare Insurance Agent

Kim Cotten · Answer

There is Medicare extra Help (LIS). This program assists individuals with limited income and resources in paying for Medicare Part D Prescription drug coverage.

Mel Brickman · Answer

Income is a determinate of the eligibility for various assistance programs on both the Federal and State levels. You should first check in with the Social Security Administration to confirm the income level that is on file for you at the federal level. If it is accurate and you have not been informed of your eligibility for the Extra Help program, then I would move on the your states Pharmacutical Assistance Programs and Medicaid assistance programs, which go under different names and have varying guidelines. Some states have specific agencies that could help you with this process.

Answered by Mel Brickman on April 21, 2025

Agent Licensed in CT

Answered by Mel Brickman Medicare Insurance Agent

Dana Dane · Answer

Please contact Medicaid as soon as possible and make an appointment to see if you qualify. There may be an office in your area. Some hospitals offer financial assistance if you are low income but do not qualify for Medicaid.

Answered by Dana Dane on April 14, 2025

Agent Licensed in OR, AZ, CA & 6 other states

Answered by Dana Dane Medicare Insurance Agent

Yasmery Vargas · Answer

You may be eligible for "extra help" through social security.  It is a pharmaceutical program that helps cover the cost of your prescriptions. Refer to ssa.gov for more information.  

You can also apply for state insurance with your local welfare office. Depending on state they can provide additional resources for local organizations that provide additional services based on eligibility.

Andrew Zurbuch, MBA · Answer

Low Income Subsidy program, also referred to as Extra Help, through Social Security.www.ssa.gov is 1 way to get there. You can call them at 18007721213.

State Pharmaceutical programs.

Your State's Medicaid you could contact.
Contact your Broker to assist you in when you can go to another Medicare Advantage Policy with Part D included or another Part D Policy. For information please go to

www.locatemedicareinsurance.com Thank you.

Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

Chad Watkins · Answer

Seniors with low income should look into these programs:
PAAD	- Pharmaceutical Assistance for the Aged or Disabled  
HAAD	- Hearing Aid Assistance for the Aged or Disabled
Senior Gold  
all can be reached at 1-800-792-9745

Tammie Rutledge · Answer

You may be eligible for Extra Help, also known as Low income subsidy from Social Security. 
You can apply online here: https://www.ssa.gov/medicare/part-d-extra-help

Fred Manas · Answer

If you have low income and are struggling to afford prescription drugs despite having Medicare Part D, you should apply for the Extra Help program, also known as the Low-Income Subsidy (LIS). This program helps individuals with limited income and resources lower their out-of-pocket costs for prescription drugs. 
Here's a more detailed breakdown of how to get help:
1. Apply for Extra Help:
You can apply for Extra Help through the Social Security Administration (SSA). You can apply online at SSA.gov/extrahelp or at your local Social Security office. 
2. Eligibility:
To be eligible, you typically need to have limited income and resources. You may also qualify if you receive Supplemental Security Income (SSI) or Medicaid. 
3. What Extra Help Covers:
Extra Help can help with your Part D drug plan premiums, deductibles, and copayments, reducing your out-of-pocket costs. 
4. New York State Assistance:
In New York, you can also look into the State Pharmaceutical Assistance Program (SPAP), which provides assistance for prescription drugs to those with low incomes. 
5. State Health Insurance Assistance Program (SHIP):
You can contact your local SHIP to get free, non-biased assistance with understanding and applying for Medicare and related programs, including Extra Help. State Health Insurance Assistance Programs 
6. Patient Assistance Programs:
Many pharmaceutical companies offer patient assistance programs that can help you get your medications for free or at a reduced cost. You can find information about these programs through RxAssist.org or NeedyMeds. 
To summarize:
Apply for Extra Help through the Social Security Administration.
Check if you qualify for SPAP or other state-specific programs.
Reach out to your local SHIP for assistance.
Explore patient assistance programs offered by pharmaceutical companies.

Steve Brauer · Answer

There are various levels of "Extra Help" that you can explore with Social Security. Its based on your Modified Adjusted Gross Income (MAGI) and they determine what level of extra help you qualify for.

David Christian · Answer

This is a wonderful questions. You want to apply for Medicare Part D Extra help. It's also known as Low Income Subsidy. It is for those within what is considered the Federal Poverty Level. You can apply for on the Social Security Administration website here: https://www.ssa.gov/medicare/part-d-extra-help.

Answered by David Christian on April 24, 2025

Broker Licensed in CA & TX

Answered by David Christian Medicare Insurance Agent

Richard Balistreri · Answer

Your best option is to contact the programs available in your state or residence. Medicare Extra Help (Low-Income Subsidy) or State Pharmaceutical Assistance Programs (SPAPs). You can apply online: https://www.ssa.gov/extrahelp or call Social Security at 1-800-772-1213.

Answered by Richard Balistreri on May 19, 2025

Agent Licensed in MO, AZ, FL & 7 other states

Answered by Richard Balistreri Medicare Insurance Agent

Patrick Stinson · Answer

You should check out the Extra Help program. Also known as Low Income Subsidy. (LIS) You can also check out to see if your state has any assistance programs.

Christopher Stewart · Answer

For low-income individuals, applying for Medicare Extra-Help can be key! For those that do not qualify for LIS (Low Income Subsidy) there are other pharmaceutical assistance programs through prescription manufacturers (Astrazeneca and others) that can help lower the cost of the medications. And if that fails, we can look at State Pharmacy Assistance programs.

Answered by Christopher Stewart on May 12, 2025

Broker Licensed in FL, AL, AZ, CO & KS

Answered by Christopher Stewart Medicare Insurance Agent

Josh Vojtush · Answer

Your best options, in my opinion, are the MSPs offered through your state's Medicaid department, or Social Security and their "Extra Help" program.

I'm a low-income senior who can't afford my prescription drugs even with Medicare Part D. What specific assistance programs should I apply for?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents Hub
A non-government resource website

I'm a low-income senior who can't afford my prescription drugs even with Medicare Part D. What specific assistance programs should I apply for?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents HubA non-government resource website

Medicare Agents Hub
A non-government resource website