Healthcare Educators


How to Get “Extra Help” with Prescriptions

by | Dec 13, 2021

The majority of Americans work up until the Medicare qualifying age of 65 to retire and enjoy the infamous golden years. Unfortunately, the golden years are getting more expensive, a large part of it due to the rising costs of healthcare and prescription drug coverage.

Rising costs of prescriptions

In the past 20 years brand-name drugs through Medicare Part D have gone up more than twice the inflation rate. Even more, in 2021, drug manufacturers set a record of price increases of 4.2 percent on more than 900 brand-name drugs. For example, according to a JAMA study, prices for 54 oral cancer drugs went up by over 40 percent from 2010 to 2018, averaging over $167,000 for a one-year treatment. It’s no surprise that older Americans are struggling with the rise in costs for prescription drugs. According to Healthy People 2020, 60 percent of Americans over age 65 are managing multiple chronic illnesses.

Seniors face difficult decisions in their healthcare options

The Kaiser Family Foundation reports that almost nine in ten seniors aged 65 and older report they are taking prescription medications. A majority of these older adults have prescription drug coverage through Medicare Part D. Even more, the majority of democrats, independents and republicans agree that prescription drug costs are unreasonable. These costs are causing many seniors to choose between groceries or their healthcare. A study from Gallup shows an estimated 7.5 million seniors foregoing care because of the cost to their pocketbooks. Even worse, 80 percent of seniors are foregoing medication that is for a serious health condition. Seniors that do have coverage from Medicare Part D are responsible to pay for prescription drugs with no cap on drug spending. This burden of cost can sometimes cost up to a third or more of a senior’s social security check.

How can a senior get “Extra Help” with prescription costs?

The Medicare Prescription Drug program is an option for seniors that offers varying drug coverages. Qualifying seniors can apply for Extra Help to pay for their monthly premiums, deductibles, and copayments that relate to the Medicare Prescription Drug program. In order to be eligible for Extra Help, Seniors must be enrolled in a Medicare Prescription Drug program.

Extra Help Eligibility

To be eligible for Extra Help, you must first be enrolled in Medicare (Part A and/or B), live in the 50 states, and meet certain income guidelines. You may hear Extra Help referred to as a Low Income Subsidy (LIS). Income guidelines or LIS limits must be no greater than $29,520 if married and $14,790 if not married.

You can calculate your income by adding your savings, investments and real estate. Don’t include the worth of your home, vehicles or items you own. If you meet these criteria, you should consider applying to the program. Learn more about your eligibility at

Get Help with the Extra Help Application

Now that you know your eligibility, ask the Medicare Educators team for assistance with submitting an Extra Help application and get help paying for your prescriptions.