Part D and Extra Help: The Practical To-Do List

Medicare prescription drug coverage (Part D) and the Extra Help program that lowers drug costs for people with limited income and resources. Drug costs are a major expense for many older adults, and many people who qualify for Extra Help never apply.

Key takeaways

• How you get Part D: through a stand-alone drug plan or a Medicare Advantage plan with drug coverage
• Yearly cap: Part D out-of-pocket drug costs are capped each year; the cap was $2,000 in 2025 and is adjusted yearly
• Most useful single change: Compare plans every fall using the Medicare Plan Finder with your exact drug list.
• Commonest mistake: Skipping Part D when you first become eligible without other creditable coverage.
• See a doctor if any of the signs under "When to speak to a doctor" below apply to you.

Do

• Compare plans every fall using the Medicare Plan Finder with your exact drug list
• Apply for Extra Help through Social Security if your income is limited
• Ask about the Medicare Prescription Payment Plan to spread drug costs across the year
• Ask your pharmacist whether a generic or preferred-tier drug would work for you

Do not

• Skipping Part D when you first become eligible without other creditable coverage
• Staying in the same plan year after year without checking costs for your medicines
• Stopping a medicine because of cost without talking to your doctor

The numbers behind the list

Here are the figures the checklist is drawn from.

If you change one thing

Compare plans every fall using the Medicare Plan Finder with your exact drug list. It is first on the list above. If the rest feels like too much at once, start there and leave the others.

Related topics

• Lowering Prescription Costs: What Published Guidance Supports (Health Insurance and Costs)
• What the Guidance Really Says About Benefits and Financial Support (Long-Term Conditions)
• The Evidence on Travel Insurance and Healthcare Abroad, Without the Hype (Travel Health)
• Annual Wellness Visit: What the Evidence Actually Says (Preventive Care)

Where to go next

• Part D and Extra Help: Separating Myth From Guidance
• New to Part D and Extra Help? Start Here
• Part D and Extra Help — the reference entry
• Medicare and Medicaid: The Complete Guide
• Medicare Enrollment Periods: What the Evidence Actually Says
• The Evidence on Medigap Policies, Without the Hype

When to speak to a doctor

Tell your doctor or pharmacist if you cannot afford a prescription before you stop taking it, since some medicines are dangerous to stop suddenly. Call 911 for a medical emergency and Poison Control at 1-800-222-1222 for a medicine overdose.

Where this comes from

• Medicare.gov — How Medicare drug coverage works
• Medicare.gov — Help with drug costs

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.