If you are on Medicare, you may be eligible for the Extra Help program. This is a low-income subsidy program that can help you pay for your prescription drug costs. In this blog post, we will discuss what the Extra Help program is, who is eligible for it, and how to apply.
Medicare Low-Income Subsidy/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.
How to Determine Who Qualifies?
To qualify for the Extra Help program, an individual must first be enrolled in Medicare Part A and/or B. Then, he or she must have a limited income and resources. The Social Security Administration (SSA) uses the following guidelines to determine who is eligible for the Extra Help program:
- An individual’s annual income must be below $18,210 for 2021 ($24,690 for a married couple).
- An individual’s resources must be limited to $14,100 for 2021 ($28,150 for a married couple).
Resources include things like bank accounts, stocks and bonds, and real estate (other than the home you live in).
How to Apply for the Extra Help Program?
If you think you may be eligible for the Extra Help program, you can apply online at ssa.gov/extrahelp, or by calling Social Security at 800-772-1213. You will need to provide information about your income and resources, as well as the names and addresses of your doctors, pharmacies, and other health care providers. Once you have applied, Social Security will contact you to let you know if you are eligible for the Extra Help program.
If you qualify for the Extra Help program, you will need to enroll in a Medicare prescription drug plan. You can do this online at medicare.gov/find-a-plan, or by calling Medicare at 800-MEDICARE. Once you have enrolled in a plan, your prescription drug costs will be covered.
If you have any questions about the Extra Help program, or if you need help applying for it, please contact us. We would be happy to help you get the coverage you need.
If You Qualify For Extra Will You Still Pay a Late Enrollment Penalty?
If you qualify for Extra Help, you may also be eligible for a Special Enrollment Period. This means that you can enroll in a Medicare prescription drug plan even if it’s outside of the annual Open Enrollment Period. You will not have to pay a late enrollment penalty as long as you enroll within 60 days of qualifying for Extra Help.
Does Low Income Subsidy Help With Advantage Plan Costs?
If you have a Medicare Advantage Plan, you may still be eligible for the Extra Help program. This can help you pay for things like your monthly premium, deductibles, and copayments. To see if you qualify, contact your plan administrator or the Social Security Administration.
Does This Help With Part B Costs?
The Extra Help program can help you pay for your Medicare Part B premium. If you have a limited income, you may be eligible for a subsidy to help pay for this cost. Contact the Social Security Administration to see if you qualify.
Can You Lose This Benefit?
Your eligibility for the Extra Help program is based on your income and resources. If your income or resources increase, you may no longer qualify for the subsidy. Contact the Social Security Administration to see if you still qualify.
In closing please keep in mind that most benefits through the state are income-based. Always check the changes each year on the State Income chart. It never hurts to keep checking and reapply each year. You also may be eligible for a state pharmaceutical program. Check with your state to see if one is offered.
We hope this blog post has helped explain the Medicare Extra Help program. If you have any questions, please contact us. You can also send us an email with any questions.