Can I get help paying for my prescriptions if I make too much for Extra Help?

What this means

• A State Pharmaceutical Assistance Program, or SPAP, is a state-funded program that pays part of your drug costs after Medicare. Only some states run one, and their income limits are usually higher than the federal Extra Help limits.
• Nearly every drug maker runs a patient assistance program for its own brand-name drugs, with its own income test and its own form.
• Switching to a different Medicare drug plan during open enrollment often saves more than any discount card, because plans price the same drug very differently.
• Discount cards are not insurance and what you pay with one does not count toward your Medicare drug costs.

What to do first

1. Ask your State Health Insurance Assistance Program counselor to compare drug plans using your exact medication list. This is free and takes about an hour.
2. Check whether your state runs a pharmaceutical assistance program using the official Medicare page on help with drug costs.
3. Ask your pharmacist or your doctor's office to help you apply to the manufacturer's patient assistance program for any brand-name drug.
4. Ask your prescriber whether a generic or a therapeutically similar drug on your plan's lower tier would work for you.

What you'll need

• Your current plan information
• Your Medicare drug plan member card
• A list of your medications and their doses
• Proof of age
• Proof of state residency
• Prior year income
• Medicare card

Where to go

• Medicare Prescription Payment Plan (M3P): https://www.medicare.gov/plan-compare/
• SHIP: Free, Unbiased Medicare Counseling: https://www.shiphelp.org/SHIPs/
• State Pharmaceutical Assistance Programs: https://www.medicare.gov/basics/costs/help/drug-costs