The Medicare Extra Help program is designed to provide financial assistance for prescription drugs to people who have Medicare. It’s also called the Part D Low-Income Subsidy. This financial assistance is based on your income and level of financial need.
The federal Medicare Extra Help program covers prescription drugs only. It’s different than state-sponsored Medicare Savings programs. Many people who qualify for Medicare Extra Help don’t even know it.
Keep reading to find out if Medicare Extra Help can help with the cost of your prescriptions.
If you have Medicare, you’re eligible for Medicare prescription drug coverage, also called Medicare Part D. But there are costs associated with this prescription drug coverage, including copays and deductibles. That’s where Medicare Extra Help comes in.
If you have limited income and savings, Medicare Extra Help can cover prescription drug copays and prescription plan premiums.
Medicare Extra Help may provide up to $4,900 of assistance annually if you qualify. This program is limited to prescription drug coverage. If you need help paying for other parts of Medicare, like Medicare Part A (hospital care coverage) or Medicare Part B (outpatient care coverage), there are other programs funded by some states that may be able to assist you.
Medicare Extra Help also doesn’t apply to Medicare Advantage (Medicare Part C) or Medigap programs.
The Medicare Extra Help program is designed to help beneficiaries with limited incomes pay for their premiums and medications. In order to qualify, you’ll need to meet the income requirements, which are based on the annual federal poverty level.
- Individual: $19,320
- Married: $26,130
There is also a limit on the value of your combined resources. Resources can include things like:
- savings accounts
- real estate aside from your primary residence
The Extra Help resource limits for 2021 are:
- Individual: $14,790
- Married: $29,520
There are exceptions to the eligibility age for Medicare Extra Help. If you’re eligible for Social Security disability before age 65 or you have certain medical conditions, you may be able to enroll in Medicare early. If you’re eligible for Medicare before age 65 because of these exceptions, you may also be eligible for Medicare Extra Help.
The specific conditions that can qualify you for early Medicare coverage include:
Tips for applying for Medicare Extra Help
- The form can be filed through the mail or done online by clicking here. Make sure to use an original form, and not a photocopy, if you’re sending your application through the mail.
- You don’t have to submit documents proving your income or assets, and you don’t have to give the government access to your bank account to complete the application.
- You don’t have to list public assistance, foster care payments, interest or dividends from investments on this application.
- You don’t have to list the value of the home you live in, your car, or any farmland property on the application.
- Listing children or grandchildren who live with you on your application could make you eligible for extra help.
You can have someone walk you through the process or fill out the form for you by calling 800-MEDICARE (800-633-4227)
There are four kinds of Medicare savings programs to help you with the costs of Medicare Part A and Part B if you need assistance. Rules for these programs vary according to the state that you live in.
These are all programs with criteria that can help you pay for Medicare in different ways:
- Qualified Medicare Beneficiary (QMB)
- Specified Low-Income Medicare Beneficiary
- Qualifying Individual
- Qualified Disabled and Working Individuals
You can call the Social Security Administration at 800-772-1213 to find out what benefits you’re qualified to receive.
Medicare Extra Help is designed to assist with the costs of prescription drugs under Medicare. This program can help with premiums, copays, and deductible costs.
The amount of assistance you receive is based on your income and your assets. Calling Medicare start the application process is the best way to find out if you qualify.