Extra Help for Part D Costs
Part D Extra help?
Anyone who has Medicare can get Medicare prescription drug coverage. Eligible beneficiaries who have limited income and/or assets may qualify for a government program that helps pay for Medicare Part D Prescription drug costs. This is called Extra Help. Medicare beneficiaries receiving the low-income subsidy (LIS) get assistance in paying for their Part D monthly premium, annual deductible, coinsurance, and copayments. Also, individuals enrolled in the Extra Help program do not have a gap in prescription drug coverage, also known as the coverage gap, or the Medicare “donut hole.” The amount of subsidy depends on the individual’s income compared to the Federal Poverty Level and resource limitations set by the Social Security Act.
The Extra Help is estimated to be worth about $4,000 per year. Many people qualify for these important savings and don’t even know it. To find out if you qualify, Social Security will need to know the value of your savings, investments, real estate (other than your home), and your income. They will need information about you and your spouse, if you are married and living together. To help Social Security determine if you are eligible for Extra Help, you will need to file an Application for Extra Help with Medicare Prescription Drug Plan Costs.
I can help you enroll in Extra Help.
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How does "Extra Help" Work?
Extra Help Medicare Part D
Beneficiaries who qualify will receive assistance with paying their monthly Part D premiums, their annual Part D deductible, and also their copayments for retail medications. There are different levels of qualification, and the subsidy level generally determines how much assistance you will get with premiums. Someone qualifying a full subsidy would have 100% of their Part D premium paid for, up to the benchmark allowed by Medicare for that year.
For example, if you get an award notice that says you have a full subsidy, and the benchmark for the year is $34, then you can choose any drug plan you like, and the LIS program will pay up to $34/month toward your premiums. Choosing a drug plan with a premium of $34 or less in that scenario would mean you pay nothing for your drug plan. Furthermore, you will pay no deductible if your plan has one, and your copays for medications are greatly reduced. If you think you may qualify, it is worth contacting Social Security for an application.
©2020 ABC Medicare Help | Not affiliated with any government agency.
How Extra Help May Apply to YOU
Applying for Extra Help
I can help you enroll!
If you want to complete the application on your own, just complete Social Security’s Application for Extra Help with Medicare Prescription Drug Plan Costs (Form SSA-1020). Here’s how:
• Apply online at www.socialsecurity.gov/extrahelp;
• Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to apply over the phone or to request an application; or
• Apply at your local Social Security office.
After you apply, Social Security will review your application and send a letter to you to let you know if you qualify for Extra Help. After you qualify, you can choose a Medicare prescription drug plan. If you do not select a plan, the Centers for Medicare & Medicaid Services will do it for you. The sooner you join a plan, the sooner you begin receiving benefits. If you aren’t eligible for Extra Help, you still may be able to enroll in a Medicare prescription drug plan.
©2020 ABC Medicare Help | Not affiliated with any government agency.