Do you need help paying for your Medicare prescription drug costs? If so, you may be eligible for extra help from the government. This assistance can lower your out-of-pocket expenses significantly. So it is worth checking into if you are struggling to afford your medications. In this blog post, we will discuss who qualifies for extra help and how to apply for it. We will also provide a list of frequently asked questions about this program.
What is Extra Help and How Does it Work?
Extra help is a program offered by the government to help people with Medicare pay for their prescription drug costs. In addition, If you qualify you will have your Part D premiums lowered. As well as out-of-pocket expenses, such as deductibles and copayments, reduced or even covered entirely. This assistance can make a huge difference for those who are struggling. This will make your medications much more affordable. So it is worth looking into.
Who Qualifies for Extra Help?
To be eligible for help with drug costs, you must:
- Live in the United States or the District of Columbia.1
- Qualify for Medicare Part A and/or be enrolled in Medicare Part B.
- Have less than $19,320 in annual income 2/$15,510 in assets (if single).2
- Have less than $26,130 in annual income 2/$30,950 in assets (if married).2
What Are the Different Levels of Extra Help?
There are four different levels of assistance available, depending on your income and assets. The higher your income and assets, the less help you will receive.
How Do I Apply for Extra Help?
If you think you may qualify for extra help with Medicare prescription drug costs, you can apply online through the Social Security Administration website, over the phone, or in-person at your local Social Security office.
You will need to provide some basic information about yourself, such as your name, address, date of birth, and Social Security number. You will also need to provide information about your income and assets. Once you have applied, the Social Security Administration will review your application and decide whether in person at your local Social Security office.
You will need to provide some information about yourself and your finances, such as your:
- Social Security number
- Bank account statements
- My most recent tax return
- List of current medications
- Proof of any other income you receive (such as from a job, pension, etc.)
What Are the Prices for Generics With Extra Help?
If you qualify for extra help, you will only have to pay $0.35 for covered generic drugs and $0.70 for brand-name drugs at participating pharmacies. You may also get other discounts on your medications, such as a lower copayment or coinsurance.
What is the Cost for Brand Name Drugs with Extra Help?
If you qualify for extra help, you will only have to pay $0.70 for covered brand-name drugs at participating pharmacies. You may also get other discounts on your medications, such as a lower copayment or coinsurance.
If I Qualify For Extra Help Do I Pay a Part D Premium?
No, if you qualify for extra help with Medicare prescription drug coverage you will not have to pay a Part D premium. Or Depending on your level of extra help a very low premium.
Does Extra Help Get Rid of Late Enrollment Penalty for Part D?
Yes, if you qualify for extra help with Medicare prescription drug coverage, you will not have to pay a late enrollment penalty for Part D.
The best advice we can give when it comes to extra help is it never hurts to ask. We find that some people do not qualify for one year and turn around and apply for the second year and get approved. The other fact to take note of is that you have to reapply each year for extra help. It does not automatically renew and a ton of people were never told that and wind up having to come out of pocket while waiting for their extra help to kick back in. The best way to avoid these issues is always to be proactive and give yourself deadlines on when to reapply so you never put yourself in financial harm’s way. If you have questions on how to apply the extra help benefits to your budget so you will know what your medications will cost. Give us a call and we can look up what level of Extra Help you have been approved for.
