If you or a loved one are a Medicare beneficiary, you may qualify for the Extra Help program. The program is designed to help beneficiaries lower the cost of their Medicare prescription drug plan. Not everyone can enroll for the plan, however.
Who can Enroll in Extra Help?
There are specific, set qualifications for who can enroll in the program. You have to:
- Live in one of the 50 states or the District of Columbia.
- Be enrolled in Medicare Part A and/or Part B.
- Have combined assets, including real estate, that are not worth more than $29,520 for married couples living together or $14,790 for those not living with a partner. This does not count your home (primary residence), vehicles, personal possessions, life insurance, burial plots/irrevocable burial contracts or any back payments from Social Security.
- Have income of no more than $19,320 or $26,130 for married couples living together.
Working out your assets can be complicated and you may want to talk to a tax advisor or financial planner. Also, you get Extra Help automatically if you have both Medicare and Supplemental Security Income or both Medicare and Medicaid. There is no need to fill out an application.
To benefit from Extra Help, you have to be signed up for a Medicare prescription drug program.
How Do You Apply?
You apply by filling out an application form on the Social Security Administration website. If you are unable to complete the application on your own and can’t ask a friend or relative for help, you can call Medicare Support Services at 940-382-4700 for assistance.
For seniors who don’t have internet access, you can fill out the form at your local library. Librarians will often help with computer use, including filling out forms. Or, the Advisors at Medicare Support Services can assist you.
The application form will also be sent to your State’s Medicare Savings Program unless you opt out. This generally means that your State will contact you with details on how to apply. This will get you even more help.
What Benefits Do You Get With Extra Help?
Once you are enrolled in Extra Help, you will get a number of benefits. Extra Help can be full or partial, depending on your income level. If you get full Extra Help, you get the following benefits:
- You can’t be required to pay a copay of higher than $3.40 for a generic drug and $8.50 for a brand name drug. (These numbers are from 2019, so check they haven’t changed).
- If you live in an institution or get home- and community-based services, you will not be charged a copay for covered drugs.
- You will not have to pay a premium for your Medicare drug plan, nor will you have to pay a deductible.
You can sometimes get a reimbursement of prescription drug costs you pay after qualifying for Extra Help, but before enrolling in a Medicare drug plan.
The Social Security Administration estimates that people enrolled in Extra Help save about $5,000 a year in prescription drug insurance costs. This is obviously a significant amount and can also make the difference when it comes to being able to afford your medications. The purpose of the program is to ensure that you can take your meds and stay healthy.
Extra Help is for people who are enrolled in Medicare and need a prescription drug plan. You can get a variety of plans which offer various types of coverage. If you are enrolled in one of these plans, Extra Help will pay for your monthly premiums and deductibles, and part of your co-payments so that your drug costs remain controlled and well below what people normally pay.
To find out more and for help getting enrolled in the program, contact Medicare Support Services today at 940-382-4700