By Beth Cooper Ingle, CSA Certified Senior Advisor®
Have you ever heard “I cannot pay for my prescriptions?” Or “my husband died, and my income has been cut dramatically.” Statements like these are common, especially for people who are retired or disabled and living on a fixed income. Prescription drugs are the tool for physicians to help people manage chronic conditions. When prescription costs are too much on one’s budget, that can be a huge problem, and health may suffer. According to CMS.gov, over 11 million seniors’ income is at 150% of the federal poverty level (FPL) or below. Many of these people struggle with the costs of their medications.
While everyone on Medicare is required to have a Medicare Prescription Drug Plan or be penalized, some people with limited resources and income may be able to obtain “extra help” with the cost of their drugs and even the prescription plan costs. In 2025, an individual with an annual income less than $23,475 and $31,725 for a married living together could be eligible for Extra Help worth about $6,200 per year. Resources an individual/couple also have to be factored into this equation. The resource limit for an individual is $17,600 or $35,130 for a married couple.
Resources include the value of the things you own. Some examples are:
- Real estate; other than your primary residence
- Bank accounts; checking, savings and certificates of deposit
- Stocks and Bonds, including US Savings Bonds
- Mutual funds
- Individual Retirement Accounts (IRAs)
Resources do not include personal possessions, your vehicles(s), life insurance policies, burial plans, property needed for self-support , such as rental property, SSI payments, housing allowances, and other resource exclusions found at SSA.gov.
When you file for Extra Help, you also can start your application process for the Medicare Savings Programs. These state programs provide help with other Medicare costs. Social Security will send information to your state unless you tell them not to on the Extra Help form. The state will contact you to file for any other programs you may qualify for.
How do you file for Extra Help? You can file an online application through www.SocialSecurity.gov. It will take you through the process step-by-step. Most of the questions on the application are about resources and income. If you are married and living with your spouse, Social Security will need their information also. To be prepared, review all your household income, identify the things you own alone, or with someone else. Do Not include your home, vehicles, burial plots, life insurance policies, or personal possessions. Gather your records in advance to save time. Also, review your resources. Social Security will need the dollar value of your bank accounts, stocks, savings bonds, mutual funds, IRAs and any other investments as well as any cash at home or real estate other than your home.
If you do not have access to a computer or are not tech savvy, you may enlist the help of Social Security, a family member, caregiver, or other third party to help you. Once you complete and submit your application to Social Security, you will receive a letter within 30 days advising you of your eligibility. If their decision is not favorable, you will have 60 days to appeal.
So, if you hear a friend saying, “I can’t afford my prescriptions, or since my husband died, it’s been hard to get by,” tell them about the Extra Help program through the Federal Government. Resources include the Social Security office, www.SSA.gov , or contact our office.
Look for Beth Cooper Ingle’s columns with Living By Your Design in future months. Her background is 37 years as a Social Security Rep in Central Illinois. For more information, contact Living by Your Design, Inc., focusing on the issues of older Americans: legal, financial, and free guidance for residential referral and healthcare issues.