Need Extra Help With Your Medicare Prescription Drug Plan Costs?

If you have limited income or resources you may qualify for Extra Help from Medicare. 

Need income medicare

Also known as Part D Low-Income Subsidy, this federal program helps pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage depending if you qualify for the “full” or “partial” Extra Help program benefit.

Qualifying on either “full” or “partial” Extra Help program is determined by your income level. A “full” Low Income Subsidy program involves receiving coverage all through the year without having to pay premiums or deductibles. It also lets you pay very little for your prescriptions and you don’t get to be subjected in the “donut hole” phase of Medicare’s Part D (Prescription Drug) Program.

For a “partial” Extra Help qualification, you also obtain a year-round coverage while having to pay reduced premiums and deductibles as well as about 15% of your drug costs.

Social Security determines if you qualify for the Extra Help program benefit. Your resources must be limited to $14,100 and your annual income to $18,210 for an individual. For a married couple living together, your resources must be limited to $28,150 and annual income to $24,690. You might still be able to get some Extra Help if your annual income is higher than the threshold. There are also a resource and income exclusions that Social Security counts off and subtracts from your limit.

To know if you are eligible for the Part D Low-Income Subsidy, you will need to file an Application for Extra Help with Medicare Prescription Drug Plan Costs (Form SSA-1020). You can apply online at www.socialsecurity.gov/extrahelp; or apply over the phone or request an application by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778). Application through your local Social Security office is acceptable.

Remember that Medicare Extra Help program’s threshold and eligibility may vary each year. A notice will be sent if your situation changes. You can reapply if your income and resources get back within the threshold.

Again, Extra Help reduces your prescription drug costs only for drugs covered by your Part D plan. If you are not enrolled in Part D plan but might be eligible for Extra Help, you can enroll for a Part D drug coverage through a Special Enrollment Period (SEP) which you can apply anytime. Your coverage will begin the first day of the month after you qualify for Extra Help and asked to join a plan. There will be no late enrollment penalty for your Medicare Part D if you enroll in Extra Help through a Special Enrollment Period.

If you need more information regarding Extra Help you may call 1-800-MEDICARE (1-800-633-4227) for further assistance with the topic.