Celebrate Medicare's Anniversary With Greater Access to “Extra Help” With Prescription Costs
On July 30, 1965, President Lyndon B. Johnson signed landmark legislation that created Medicare and Medicaid. At his side was former President Harry Truman, a champion of national health insurance.
Medicare is a federal health insurance program for people 65 and older and people with disabilities and kidney disease. Medicaid is health coverage for people who have low incomes.
From the beginning, Medicare provided health insurance to nearly all Americans ages 65 and older who received Social Security or railroad retirement benefits. “Original” Medicare had Part A (Hospital Insurance) and Part B (Medical Insurance).
Medicare has changed as the needs of Americans have changed. In 1972, the program was expanded to cover:
- People receiving Social Security disability benefits for at least 24 months.
- People with End-Stage Renal Disease (ESRD) who need dialysis or a kidney transplant.
Prescription drug coverage added in 2003
The biggest changes in Medicare came about more than 20 years ago with the Medicare Prescription Drug Improvement and Modernization Act (MMA). This 2003 law created Part D, a prescription drug benefit. Coverage is optional for anyone with Medicare who enrolls in a private plan.
The law also created the Extra Help program that provided full and partial subsidies for people with limited resources and income to help them pay for prescriptions. The greater their financial need, the greater their subsidy.
More Medicare beneficiaries can now get help
As of January 2024, more people can get Extra Help with Medicare prescription coverage.
A new law ended partial subsidies, increased resource and income limits, and expanded savings.
Medicare beneficiaries who have Extra Help pay:
- $0 premiums.
- $0 deductibles.
- No more than $4.50 for generic drugs.
- No more than $11.20 for brand-name drugs.
- $0 for each covered drug once total drug costs reach $8,000 in a year.
How to apply for Extra Help
In most cases, you must have resources and income below a certain limit to get Extra Help. These limits may change every year. Also, you must live in the United States. Some people automatically get Extra Help and don’t need to apply. They include people with Medicaid and people with Medicare who receive Supplemental Security Income (SSI).
If you or someone you know may be eligible for Extra Help, the easiest way to apply is with our online application. For more information, visit Help with drug costs.
To learn more about Medicare, read our publication or visit Medicare.gov.
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