Extra Help and Medicare Savings Programs can lower drug costs and premiums for low-income San Diego seniors. Learn who qualifies and how to apply.
By Patricia Nguyen, CDP · October 03, 2026
When a parent's care costs start to climb, families often focus on the big-ticket items such as assisted living or in-home help. Meanwhile, Medicare costs quietly eat into a fixed income: Part B premiums, Part D prescription premiums, deductibles, and copays. Two programs exist to reduce those costs for people with limited income and resources, and many eligible older adults in San Diego County are not enrolled.
The first is Extra Help, also called the Part D Low-Income Subsidy, run through the Social Security Administration. The second is a set of Medicare Savings Programs, run in California through Medi-Cal and administered locally by the County of San Diego. Neither requires full Medi-Cal, and neither is a loan. Both can be worth hundreds of dollars a year, sometimes more.
Extra Help reduces or eliminates the Part D premium and deductible for people who qualify and sharply lowers copays at the pharmacy. For a parent taking several expensive medications, that can change the monthly budget noticeably. Income and resource limits change every year, so check current numbers with Social Security rather than relying on a figure from an older article.
You can apply through Social Security at 800-772-1213 or at ssa.gov. If your parent already receives full Medi-Cal, Supplemental Security Income, or help from a Medicare Savings Program, they are usually enrolled in Extra Help automatically. It is still worth confirming that the notice arrived, because a missed letter can leave someone paying full price at the pharmacy counter.
Once approved, a person on Extra Help can generally change Part D plans through a special enrollment period rather than waiting for the fall window. That matters if the current plan does not cover a key drug or the preferred pharmacy is far away.
A practical tip for caregivers: bring a current list of every medication, the dose, and the pharmacy to your appointment. Whether you meet with HICAP or call Social Security, having the list ready lets the counselor check each drug against plan formularies and spot savings you would otherwise miss.
Medicare Savings Programs pay some or all of the Part B premium, and in some cases deductibles and coinsurance. In California these are handled through Medi-Cal, and the state has removed the asset test for most Medi-Cal programs in recent years, which opened the door for many people who were previously turned away. Rules and thresholds have shifted more than once, so ask the county to run a fresh screening even if your parent was denied in the past.
Applications go through the County of San Diego Health and Human Services Agency. You can apply online through BenefitsCal, by phone, or in person at a regional office. Gather proof of income, your parent's Medicare card, and identification. If the paperwork feels overwhelming, a local counselor can sit with you and walk through it.
San Diego has free, unbiased counselors who do this every day. The Health Insurance Counseling and Advocacy Program, known as HICAP, can screen for Extra Help, explain Medicare Savings Programs, and compare Part D and Medicare Advantage plans without selling anything. The statewide HICAP line is 800-434-0222.
The Area Agency on Aging, part of Aging and Independence Services, can connect you with HICAP and with other benefit screening. Call the Aging and Independence Services Call Center at 800-339-4661. For general Medicare questions, 1-800-MEDICARE (800-633-4227) is available around the clock.
If your parent is considering a move to assisted living or memory care, sort out these benefits before the move. Lower medication and premium costs improve the monthly budget you will use when comparing communities, and you can verify any facility's record on the California Community Care Licensing site at ccld.dss.ca.gov. Veterans should also ask VA San Diego in La Jolla about pharmacy benefits, since some veterans do well with VA drug coverage alongside Medicare.
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