Get Extra Help to pay for your prescriptions

What is Extra Help?

Extra Help is a program offered by Medicare to help people with low income and limited resources pay for Medicare prescription drug costs. Many people qualify for these savings and don’t even know it.

  • Get help paying your Medicare plan’s drug costs
  • Have no coverage gap
  • Have no late enrollment penalty

You automatically qualify for lower prescription costs through Extra Help if you have Medicare and meet any of these conditions:

  • Have full Medicaid coverage
  • Get help from your state Medicaid program paying your Part B premiums (from a Medicare Savings Program)
  • Get Supplemental Security Income (SSI) benefits
Even if you automatically qualify this year, you may not qualify for Extra Help next year. Changes in your income or resources may cause you no longer to qualify for lower prescription drug costs through one of the programs listed above. You’ll get a notice (on grey paper) by the end of September if you no longer automatically qualify. Even if you get this notice, you may still qualify for help with prescription costs, but you need to apply to find out.

  • If your copayment amounts change next year, you’ll get a notice (on orange paper) in the mail in early October with the new amounts.
  • If you don’t get a notice from Medicare, you’ll get the same level of Extra Help that you got for this year.

The Centers for Medicare & Medicaid Services (CMS) started the Best Available Evidence (BAE) policy to deal with Extra Help eligibility. BAE makes sure that people getting Extra Help aren’t charged too much or have higher copayments than you’re supposed to.

According to CMS, all plan sponsors, like Leon Medical Centers Health Plans, must accept BAE sent by someone applying for Extra Help if they are eligible, even if Medicare records don’t show it. Once you’ve sent Best Available Evidence to us, we will ask CMS to change your status in their system.

Some acceptable forms of Best Available Evidence are:

  • A copy of your Medicaid card (if you have one)
  • A copy of a state document that shows you have Medicaid
  • A print-out from a state electronic enrollment file or from your state's Medicaid systems that shows you have Medicaid
  • A screen print from the State's Medicaid systems showing Medicaid status
  • Any other document from your state that shows you have Medicaid
  • A document from your state that shows you have Medicaid and are getting home- and community-based services
  • Social Security Administration (SSA) Award Letter
  • An “Application Filed by Deemed Eligible” (SSA publication HI 03094.605) confirming that the beneficiary is “automatically eligible for extra help”
To learn more about CMS’s Best Available Evidence (BAE) policy, visit

  • Call the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778) between 7:00 a.m. to 7:00 p.m., Monday through Friday.
    Or visit Social Security Online.
  • Call Medicare at 1-800-Medicare (TTY 1-877-486-2048), 24 hours a day. Or visit Medicare Online
  • Call the Florida Department of Children and Families at 1-866-762-2237 (TTY 711) between 7:00 a.m. to 6:00 p.m., Monday through Friday.
    Or visit Myflorida. Online.
  • Call us at the phone number on your member ID card.