Extra Help with Medicare drug costs in Santa Clara County

A directory listing, not an eligibility decision.

UniHealth can identify a possible match, but the responsible program makes the final decision.

What to know

Why it may fit: Your circumstances can be checked against the program’s published guidelines.
What to do next: Extra Help lowers what you pay for Medicare drug coverage. You get it automatically if you have Medi-Cal, QMB, SLMB, QI or SSI. Otherwise, apply with Social Security.
Who runs it: Social Security / CMS

What the program may consider

Automatic status through full Medi-Cal, an MSP, SSI or other deemed status
Direct-application income limit
Direct-application resource limit and exclusions

How to get it

Extra Help lowers what you pay for Medicare drug coverage. You get it automatically if you have Medi-Cal, QMB, SLMB, QI or SSI. Otherwise, apply with Social Security.

Before you start

You need this first Original Medicare. You must have Medicare Part A or Part B.
Having this helps Qualified Medicare Beneficiary (QMB). With QMB, you get Extra Help automatically, even if your savings are above Extra Help's own limit.
Having this helps Specified Low-Income Medicare Beneficiary (SLMB). With SLMB, you get Extra Help automatically, even if your savings are above Extra Help's own limit.
Having this helps Qualifying Individual (QI). With QI, you get Extra Help automatically, even if your savings are above Extra Help's own limit.
Having this helps Aged, Blind and Disabled Federal Poverty Level Medi-Cal. With Medi-Cal, you get Extra Help automatically.
Having this helps Supplemental Security Income / State Supplementary Payment (SSI/SSP). With SSI, you get Extra Help automatically.

How to apply

Social Security's Extra Help application

Apply online, by phone, or on paper. Social Security also sends your answers to the state, unless you say no. Your county then mails you forms for help with Medicare costs. Send them back to finish that application.

The same application can also ask for Qualifying Individual (QI), Qualified Medicare Beneficiary (QMB) and Specified Low-Income Medicare Beneficiary (SLMB).

OnlineApply for Extra Help onlineSocial Security's Extra Help application. You click to sign at the end.
PhoneSocial Security: 1-800-772-1213TTY 1-800-325-0778
MailPaper Extra Help form by mail: Social Security Administration, Wilkes-Barre Direct Operations Center, P.O. Box 1020, Wilkes-Barre, PA 18767-9910Sign the paper form in black ink before you mail it.
PhoneHICAP free Medicare counseling: 1-800-434-0222Free, unbiased help with Medicare choices.
PhoneSanta Clara County benefits line: (408) 758-3800Apply or ask questions by phone, 8 a.m. to 5 p.m.

You can also use: California's one application for Medi-Cal, CalFresh and cash aid

Online it is BenefitsCal. On paper it is the SAWS 2 PLUS. One application can ask for several programs at once.

Getting help

Someone can apply for you

Anyone can help you apply. A helper can fill in the form with you. You still sign it yourself: click to sign online, or sign the paper form in ink. A helper signs for you only if you cannot sign. Helping you apply does not let Social Security share your case with that helper.

A helper can fill it out, but you still sign.

What happens after you apply

If you have Medi-Cal, QMB, SLMB, QI or SSI, you get Extra Help automatically. You do not need to apply. Applying at your county for Medi-Cal or help with Medicare costs can bring it too.
If you have one of these
Medicare
If it is not automatic, apply with Social Security. A helper can fill in the form with you, but you sign it. Extra Help counts from the first day of the month you apply. If you start online but do not finish, the day you started may still count.
Social SecurityA helper can help with this
Social Security checks your answers against tax and other records. It may ask you about your income or savings.
Social SecurityA helper can help with this
Social Security mails you a letter that says yes or no.
Social SecuritySocial Security does not say how long this takes.
Social Security also sends your answers to the state, unless you said no. The county then mails you forms SCD 2269 and SCD 2270. Sign and return them. If you mark that you do not want Medi-Cal, the county closes that application.
Unless you said no on the Extra Help form
The countyA helper can help with this Return them within 10 days. If you miss it, the county calls or writes once more and gives 10 more days.The county decides within 45 days of hearing from the state.
Medicare tells your drug plan. The plan lowers your costs and pays back what you overpaid since Extra Help started.
If you already have a Medicare drug plan
Your health plan
If you have no Medicare drug coverage, Medicare signs you up for a drug plan. It starts about 1 to 2 months later. You can pick a different plan. The choice is yours. HICAP gives free, unbiased help.
Only if you have no Medicare drug coverage
Medicare
Need medicine before your drug plan starts? Ask the pharmacy about LI NET. It is short-term Medicare drug coverage for people with Extra Help.
Only if you have no drug plan yet
The program or providerA helper can help with this

What only you can do

Sign the application yourself. Click to sign online, or sign the paper form in ink.
Answer Social Security's questions about your income and savings.
Keep the drug plan Medicare picks, or choose your own. The choice is yours. HICAP gives free, unbiased help.
Stay in a Medicare drug plan. Extra Help works only through a drug plan.
Tell Social Security if you marry, divorce, or separate, or if your spouse dies.
If Social Security mails you a review form, fill it out and send it back.

How long it takes: About 1 to 4 months. It counts back to the month you applied, or to when your Medi-Cal, QMB, SLMB or QI started.
You are enrolled when: You have a letter saying you get Extra Help. You are in a Medicare drug plan that charges the Extra Help amounts. In 2026 that means no deductible. Copays are no more than $5.10 for generic drugs and $12.65 for brand drugs. Some people with Medi-Cal pay less.
To keep it: If you got it automatically, it renews each year. You must still have Medi-Cal, QMB, SLMB, QI or SSI in some month from July to December. If not, you get a letter and must apply to Social Security. If Social Security approved you, it may review your case. Stay in a drug plan.

Coming changes

Starting January 4, 2027: Some people who are not citizens lose Medicare on January 4, 2027. Citizens and green card holders keep it. Without Medicare, Extra Help ends too.

Choosing a Medicare plan is your decision. UniHealth does not choose, recommend, or enroll anyone in Medicare plans. For free, unbiased help, call HICAP at 1-800-434-0222.