Help paying for medicines

1. Extra Help with Medicare drug costs

Extra Help is a Medicare program for people with low income and savings. It helps pay your Part D drug plan's monthly premium, its deductible and what you pay at the pharmacy.

You get it on its own if you have full Medicaid, a Medicare Savings Program, or SSI. Otherwise, you apply with Social Security.

The 2026 limits: income under $23,940 a year for one person, or $32,460 for a married couple. Savings and other resources under $18,090 for one person, or $36,100 for a couple. Applying also starts a Medicare Savings Program application with your state, unless you say no.

Apply for Extra Help (ssa.gov)

Source: Medicare.gov, Help with drug costs, read 2026-10-28. It links to the same Social Security page.

2. The Medicare Prescription Payment Plan

This lets you pay your Part D drug costs in monthly bills from your plan, spread across the year (January to December), instead of all at once at the pharmacy.

Anyone with a Medicare drug plan, or a Medicare Advantage plan with drug coverage, can use it. Every plan offers it. Joining is your choice and costs nothing. It does not lower what you pay. It only spreads it out. Call your plan to join.

How the Payment Plan works (medicare.gov)

Source: Medicare.gov, What's the Medicare Prescription Payment Plan?, read 2026-10-28.

3. The 2026 yearly limit on Part D costs

In 2026, once what you pay out of pocket for covered Part D drugs reaches $2,100, you pay nothing more for covered Part D drugs for the rest of the year. Help paid for you, like Extra Help, counts toward the $2,100.

In 2027 the limit is $2,400. No Part D plan can have a deductible over $615 in 2026.

Costs in Medicare drug coverage (medicare.gov)

Source: Medicare.gov, Costs in Medicare drug coverage, "Medicare drug coverage stages", read 2026-10-28.

4. State drug help (State Pharmaceutical Assistance Programs)

Some states have a program that helps pay your drug plan premium, your share of drug costs, or both. What it pays may count toward the $2,100 yearly limit. Each program sets its own rules.

See if your state has one (medicare.gov)

Source: Medicare.gov, Costs in Medicare drug coverage, read 2026-10-28. The state list is the one Medicare.gov's Help with drug costs page links to.

5. Medicaid, if you qualify

Medicaid covers prescriptions. If you have full Medicaid and Medicare, you get Extra Help on its own. Low income with Medicare? A Medicare Savings Program can also lead to Extra Help.

On Medicaid and facing the work rule: keep your Medicaid

60 or older: check Medicare Savings Programs and Extra Help

Source: Medicare.gov, Help with drug costs ("Who gets Extra Help automatically?"), read 2026-10-28. Your state Medicaid office decides who qualifies.

6. Programs run by drug companies

Some companies that make medicines run programs that help people with Medicare drug coverage pay for their drugs. Each company sets its own rules. Contact the company to ask if you can get help. Your pharmacist can tell you which company makes your medicine.

This page names no company and gets nothing from any.

Search for a company program (medicare.gov)

Source: Medicare.gov, Costs in Medicare drug coverage ("Pharmaceutical Assistance Programs"), read 2026-10-28.

7. Ask the cash price before you pay

Sometimes the pharmacy's cash price, without your insurance, is lower than what you would pay through your plan. Federal law says your plan cannot stop the pharmacy from telling you that, or punish it for telling you. The law does not make the pharmacy say it first, so ask.

• Private and job-based plans: the Patient Right to Know Drug Prices Act, Pub. L. 115-263 (Oct. 10, 2018), now 42 U.S.C. 300gg-19b.
• Medicare drug plans (Part D and Medicare Advantage with drug coverage): the Know the Lowest Price Act of 2018, Pub. L. 115-262, now 42 U.S.C. 1395w-104(m), for plan years from January 1, 2020.

What to ask at the counter: "What would I pay for this with my insurance? What is your cash price without insurance? Which is lower?" You can ask the same thing for a generic or a 90-day supply. Then pick before you pay.

The trade-off: a cash purchase may not count toward your plan's deductible or yearly out-of-pocket limit. For a Medicare drug plan, Medicare.gov says a drug bought with a discount card instead of your plan does not count toward your Medicare deductible or out-of-pocket maximum. If you are close to the 2026 Part D yearly limit, paying through the plan may save more over the year. Ask your plan how a cash purchase is counted.

In Texas, a law for PPO plans makes the insurer credit a payment you make straight to a provider for a covered service or supply, with no claim filed, toward your deductible and out-of-pocket maximum when it is less than the plan's average network rate (Tex. Ins. Code 1301.140, H.B. 2002, 2023, plans issued or renewed from January 1, 2024). The insurer must post how to claim it. Ask your insurer whether a pharmacy purchase counts and what papers it needs.

Who this helps most: people with a high deductible or a Medicare drug plan. With Medicaid, federal rules keep drug copays small (42 CFR 447.53), so this matters less.

Some pharmacies and websites post their cash prices. Compare them with what you pay under your plan. This page names none and gets nothing from any.

Sources, read 2026-10-28: Pub. L. 115-263 and Pub. L. 115-262 (govinfo.gov); Medicare.gov, Help with drug costs (discount cards and the deductible); Texas H.B. 2002, 88th Legislature, enrolled text (capitol.texas.gov); 42 CFR 447.53 (eCFR).

8. Safety

Check your medicines against the FDA label at harnesshealth.ai/medcheck. Do not stop or change a medicine to save money without asking your prescriber or pharmacist first.

Who can help you choose

A SHIP counselor (State Health Insurance Assistance Program) can help you compare plans and apply: shiphelp.org. Medicare: 1-800-633-4227 (TTY 1-877-486-2048).

Source: Medicare.gov, Help with drug costs, read 2026-10-28.