Extra Help v. Medicaid

Based on income and resources, you may be qualified for Extra Help or Medicaid and not even know about it.

Extra Help helps lower your prescription costs only. Medicaid covers a wide range of your medical services. In general:

If you have Medicaid, you may already qualify for Extra Help.
If you don't have Medicaid, you could be eligible for Extra Help.

What's the difference?

Extra Help

Helps Medicare beneficiaries afford prescription drug costs under Part D and is provided by Social Security Administration (SSA).

Key Benefits

Lowers or eliminates:
Part D premiums.
Rx deductibles.
Rx copayments.
No late enrollment penalty for Part D.

Eligibility Criteria

Based on income and resources*.
Must be enrolled in Medicare Part A or B.
Doesn't require full Medicaid eligibility.
A U.S. citizen or legal resident.

Apply

Online at ssa.gov or social security offices.

Income

Are single making $23,475/year or less.
Married (living together) making $31,725/year or less.
Have limited assets: under $17,600 (single) or $35,130 (married).

Medicaid

A state-run program that provides comprehensive health coverage for low-income individuals and is provided by state and federal government partnerships.

Key Benefits

Covers hospital, medical, and sometimes dental care.
May pay for Medicare premiums (Part A & Part B).
May automatically qualify someone for Extra Help.

Eligibility Criteria

Varies by state.
Includes income, assets, age, disability, etc.
Can cover non-Medicare individuals as well (e.g. children, pregnant people).
Everyone at any age, regardless of immigration status.

Apply

State website or local state office.
Oregon residents Click Here.

Guiding you to the best care solutions.

Navigating healthcare programs can be confusing. Whether you're wondering if you qualify for Medicaid, Extra Help with prescription drug costs, or both, we're here to guide you. Our team can help you understand the differences, eligibility requirements, and how each program could lower your healthcare expenses.