We help people make sense of Medicare Advantage,
Supplement and Part D Drug Plans.
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Managing your healthcare needs on a tight budget can lead to a lot of stress. When it comes to this problem, you are not alone. Many seniors struggle with increasing prescription drug costs, high deductibles, and very expensive copays. The good news is that there are helpful resources out there!
Sometimes simply comparing Medicare plans just isn’t enough. The Medicare Extra Help program offers relief to people with limited income and resources to pay the costs of Medicare prescription drug coverage that is sufficient. Keep on reading to find out how Medicare Extra Help can be an asset to your financial situation.
Medicare Extra Help is a federal assistance program which is administered by the Social Security Administration. It helps individuals with limited income and resources pay for high Medicare prescription drug costs (Medicare Part D). This is one way to help avoid paying the Part D penalty. If you qualify, also referred to as Low-Income Subsidy (LIS), you will get assistance towards part D premiums, annual deductibles, and prescription drug co-payments.
You will automatically qualify for this program if you currently receive Medicare and also meet the following conditions:
The program is also available through income and asset eligibility even without the above requirements. For 2020, an individual could qualify for the program if their annual income was at or below $19,140 and their assets did not exceed $14,610. For married couples, the income threshold was $25,860 and the asset threshold was $29,160.
According to ssa.gov assets do include the value of things you own, including:
The amount of assistance you actually receive through the program can vary depending on your income. In general, the benefits tend to include:
If you qualify for Medicare Extra Help because you are currently receiving Medicare Medicaid, are enrolled in a savings plan, or you receive SSI benefits, then you do not need to manually apply. You will automatically qualify for extra help and will be registered in the program without further action being required. For questions regarding which enrollment period is coming up next and how they work, please review the different Medicare enrollment periods so you are prepared to get the drug plan you need.
If you are applying based on income and asset eligibility, then you will need to fill out an official application. You may fill out the Medicare Extra Help application online at ssa.gov, or you can apply in-person at your local office. You can also apply through phone or mail. For more information, please feel free to contact one of our agents or to visit the Social Security Administration website.
First, make sure you fully understand what Medicare is, and all of the parts available. Then, move towards the income-based details. Once you are approved, you will receive an official eligibility notice from Medicare. Provide the eligibility notice and other documentation such as Medicaid card to the insurer in order to start receiving lower prescription drug expenses. Depending on your level of eligibility your out-of-pocket costs will also be significantly reduced and in some cases, they will be eliminated completely. It is important to remember income and asset eligibility vary every year so even though you qualify this year, you may not qualify the next.
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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.