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.
Medicare Extra Help is available if you’re eligible for Original Medicare. Under current U.S. law, people become eligible for Medicare at the age of 65. This program is less about age requirements and more about your income and assets.
eligibility for medicare extra help
If you’re 65 years old, Medicare eligible, and and meet the following criteria, you’re eligible for Medicare Extra Help:
- You’re a U.S. citizen residing in the 50 states or the District of Columbia.
- Your resources (stocks, bonds, savings accounts) total less than $14,390 if you’re an individual or $28,720 if you’re a married couple (note that your house, car, and other material assets don’t count toward your resources in this case).
- Your annual income totals $18,735 if you’re an individual or $25,365 if you’re a married couple. If you have other family members who live with you, live in Alaska or Hawaii, or have residual earnings from work, you may still be able qualify with a higher income.
There are exceptions to the age of eligibility for Medicare Extra Help. If you’re eligible for Social Security even though you’re not yet 65, or if you have certain medical conditions, you may be able to collect Medicare early. If you’re eligible for Medicare before the age of 65 because of these exceptions, you may also be eligible for Medicare Extra Help.
Exceptions for the Medicare age of eligibility include:
- end stage renal disease (ESRD)
- Lou Gehrig’s Disease
Tips for applying for Medicare Extra Help
Applying for a program like Medicare Extra Help might seem like a lot of paperwork. But the application process might be easier than you think. Here are some tips:
- 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.
There are four kinds of Medicare Savings programs to help you with the costs of Medicare Part A and Part B premiums, 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
- Specified Low-Income Medicare Beneficiary
- Qualifying Individual
- Qualified Disabled and Working Individuals
Call the federal 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 the Medicare office to start the application process is the best way to find out if you qualify.