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?
Answered by 31 licensed agents
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.
Answered by Mark Cunningham on April 28, 2025
Agent Licensed in CO, FL, GA, NE & WY
Answered by Larry Dalton on May 2, 2025
Broker Licensed in OK & TX
Answered by Tony Capraro III on May 9, 2025
Agent Licensed in NH & ME
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
Answered by Tasha Riggs on April 12, 2025
Broker Licensed in CO, AZ, HI & 10 other states
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.
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.
Answered by Andrew Zurbuch, MBA on April 16, 2025
Broker Licensed in IN, FL, KY, MO, OH & TN
First, you can see if you qualify for "Extra Help." You can visit Medicare.gov/extrahelp to learn more about the program or call 1-800-MEDICARE which is 1-800-633-4227. TTY Users should call 1-877-486-2048.
If you qualify, this can reduce or eliminate your Part D premiums, deductibles, copays, and coinsurance.
You can use prescription discount cards. This includes Clever Rx and Good Rx, and many retail areas offer programs such as Kroger and Walmart with their own savings programs.
State Pharmaceutical Assistance Programs can also help with reducing premiums or copays. You can contact your local SHIP (State Health Insurance Program) and talk to a counselor or Medicaid office to check on eligibility and also possible receive enrollment assistance.
Drug Manufacturers sometimes have programs of their own to provide assistance. You can see if the drug manufacturer offers a patient assistance program to help cover the costs of the medications.
You can check the Health Resources and Services Administration website at hrsa.gov. You can check to see if there is a Federally Qualified Health Center near you. Federal Qualified Health Center pharmacies offer medications at reduced prices under the federal 340B program.
In addition, there are foundation grants available in some cases. PAN Foundation, HealthWell, Patient Services Inc, CancerCare, NORD, Patient Advocate Foundation, Good Days, LLS and more offer grants for disease specific conditions. There are often chronic illness funds within these nonprofit and charitable foundations that can assist with prescription costs, and some may help with premiums and potentially travel costs.
Finally, one thing to consider is checking into the Medicare Prescription Payment Plan with your prescription drug coverage. The insurance industry also calls it MP3, and it allows you to spread your costs over the year with capped costs instead of all at once.
Answered by Steven Whetstine on June 21, 2025
Agent Licensed in AZ, ID, IN & 6 other states
You ate l are not alone., others must deal with the same situation.
A sporadic program you may wish to look into is called:
Extra Help/LIS
THIS IS A SPECIAL PROGRAM FOR A PERSON WITH LOW-INCOME AS YOU DESCRIBED.
I hope this was of help. Best wisheDaniel Maisel Insurance - Medicare Agency
(909) 319-5324. Www.InsureItDan.com
http://planenroll.com/?purl=yZLgRcNz
Answered by Daniel Maisel on June 23, 2025
Broker Licensed in CA, AZ, MI & NV, OH, TN & WA
Answered by Danny Radisewitz on April 7, 2025
Broker Licensed in SD, IA, MN & ND
Answered by Angela Ellington on April 21, 2025
Agent Licensed in CA, AZ, FL & 9 other states
Answered by Sandy Johnson on July 3, 2025
Broker Licensed in LA, AL, AR & 11 other states
Answered by Kim Cotten on May 19, 2025
Broker Licensed in FL, AL, AR & 40 other states
Answered by Mel Brickman on April 21, 2025
Agent Licensed in CT
call me, at 5735135727 i would be glad to help you
thanks Eddie
Answered by Eddie Tune on July 1, 2025
Broker Licensed in MO, AL, AR & 19 other states
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.
Answered by Yasmery Vargas on April 15, 2025
Agent Licensed in PA
Answered by Dana Dane on April 14, 2025
Agent Licensed in OR, AZ, CA & 6 other states
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
Answered by Chad Watkins on May 14, 2025
Agent Licensed in NJ, AK, AL & 48 other states
You can apply online here: https://www.ssa.gov/medicare/part-d-extra-help
Answered by Tammie Rutledge on April 3, 2025
Broker Licensed in WA, AZ, FL & ID, MT, OR & TX
Hrandolph
2693394433
Answered by Harold Randolph on May 21, 2025
Broker Licensed in MI, IN, KY & OH
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.
Answered by Fred Manas on May 14, 2025
Agent Licensed in NY, CT, DC & 7 other states
You may also qualify for Medicaid with the states you live in
Answered by Gary Henderson on June 14, 2025
Agent Licensed in TX, AK, AL & 46 other states
Answered by Steve Brauer on April 8, 2025
Broker Licensed in AZ & CA
Answered by David Christian on April 24, 2025
Broker Licensed in CA & TX
When you are approved for Medicaid and you have Medicare parts A & B, you are dual eligible for DSNP - dual special needs plans, which will pay for virtually everything, $0 co-pays back to back.
Answered by Andre Cabral on June 9, 2025
Agent Licensed in NJ
Answered by Richard Balistreri on May 19, 2025
Agent Licensed in MO, AZ, FL & 7 other states
Answered by Patrick Stinson on April 27, 2025
Broker Licensed in TX, AR, AZ & 9 other states
Answered by Christopher Stewart on May 12, 2025
Broker Licensed in FL, AL, AZ, CO & KS
The main program to help with Medicare prescription drug costs is Extra Help, also known as low-income subsidy (or LIS). This program will dramatically lower the costs of your medications, both name brand and generics, putting a cap on your copays along with possible help towards plan premium costs and deductibles. Extra Help allows for a slightly higher income level than Medicaid (your state aid agency) allows for so you may still qualify for Extra Help even if you don't qualify for Medicaid.
Medicaid is another program you can apply for that can go beyond prescription cost help and may also help pay your Medicare Part B premium and possibly even medical copays. Again, this is where a licensed agent is so helpful as they should know what questions to ask to determine eligibility and be able to help walk you through the application process.
Answered by Abigail Turner on June 23, 2025
Broker Licensed in KS, AZ, KY & 8 other states
Second, you may be in a state that has a State Pharmaceutical Assistance Program.
Third there's the Medicare Prescription Payment Plan (M3P). M3P allows that the costs of prescription co-pays be spread over the calendar year.
Finally, if you qualify based on income, you can apply for Medicaid in your state.
Answered by Michael Pane on June 12, 2025
Broker Licensed in NY, CO, FL & 16 other states
Answered by Josh Vojtush on April 8, 2025
Broker Licensed in OH, FL, IL & MI, NC, SC & VA
Answered by Mark Enright on June 23, 2025
Broker Licensed in IL, CO, FL & 6 other states
These programs are based primarily on income and assets, and many people qualify without even realizing it. Navigating the options can be confusing, which is why speaking with a knowledgeable, licensed health insurance expert is so important.
If you're in New York, I’d love to connect and provide a no-cost, personalized advice to help you get the coverage you deserve.
Answered by David Alelishvili on May 27, 2025
Broker Licensed in NY
Tags: Advice for Seniors Medicare Part D Prescription Drug
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