Medicare’s “Extra Help Program” May Provide as Much as $4,000 to Assist With Prescription Drug Costs


14 - CopyAs health care costs continue to rise, many individuals wonder if they will be able to buy groceries and get the prescriptions they need. Thankfully, Medicare understands this is a problem facing many seniors in our country today and has created the Extra Help program. This program doesn’t replace Medicare prescription drug coverage, but supplements it and covers costs associated with monthly premiums for this coverage, the annual deductibles and any co-payments required for the prescriptions. It is estimated that the program is worth approximately $4,000 each year.

Individuals must reside in the United States and must have limited resources. A single person requesting Extra Help cannot have resources more than $13,650, and married couples living together are limited to $27,250 in resources. When evaluating resources, Medicare only looks at assets such as stocks and bonds and bank accounts. The applicant’s residence, vehicle, life insurance policy and various other assets don’t usually count when the agency makes the determination as to whether or not a person is eligible.

In addition, Medicare has established income guidelines for individuals wishing to take advantage of this program. An individual must have an annual income of less than $17,655 to qualify for the program, while a married couple cannot have a combined income of more than $23,890 each year. Those who make above these limits may still be eligible for help, especially those who support other family members living in the home, those who live in Hawaii or Alaska and those who get earnings from work. The Centers for Medicare and Medicaid can provide more information for those who find they are in one of these situations.

Actions To Take Today

  1. Download our “Qualify for The Extra Help Program Guide!” Here.
  2. Determine your eligibility for the program. There are a number of ways to do so. If you have any of the following documents, you qualify for help: a notice provided by the agency stating you are automatically qualified, automatically enrolled or that your co-payment amount is changing, a Notice of Award from the Social Security Administration or a Supplemental Security Income award letter. In addition, those living in an institution and those receiving home and community-based services often qualify. Medicare can assist in determining eligibility also.
  3. Apply for the program. The easiest way to do so is to use the online application, as it walks you through the application and provides self-help screens. Each screen offers details on what information will be needed, so there are no questions. For those lacking access to a computer, the application may also be completed by calling Social Security and completing the application or requesting a printed form to fill out or by applying at a local Social Security office.
  4. Choose a plan that best meets your needs, as there are many to select from. Those who fail to do so will find the Centers for Medicare and Medicaid Services selects a plan. The sooner the plan is selected, the sooner you may begin obtaining these benefits.

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September 11, 2018 |

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