Care Connection Aging & Disability Resource Center

The “Extra Help” Program 

Medicare beneficiaries who have limited income and resources may qualify for extra help to pay for prescription drugs costs. This Extra Help program from Medicare provides financial assistance for beneficiaries who have limited income and resources. Those who are eligible for this program will get help paying for monthly premiums, yearly deductibles, prescription coinsurance and copayments and will have no gap in coverage.

Some people are automatically eligible for the Extra Help program.  Those include people who are: full benefit dual eligibles (Receive Medicare and Medicaid); Social Security Insurance recipients with Medicare and Medicare Savings Programs participants.

Some people must apply through the Social Security Administration. This includes Medicare beneficiaries with income below 150% FPL who meets an asset test—i.e.—beneficiaries who have a yearly income (in 2009) below $16,245 ($21,855 for a married person living with a spouse and no other dependents) and resources (in 2009) less than $12,510 ($25,010 for a married person living with a spouse and no other dependents).

Generally, dual eligibles and others deemed eligible for the Extra Help Program pay no Part D plan premiums or deductibles, but pay $1.10 or $2.40 for generic drugs and $3.20 or $6.00 for brand-name drugs, depending on their income.

Please note that the dollar amounts are subject to change. Please call 877-393-1090 for more information. The content above was adapted from the Centers for Medicare and Medicaid web page: http://www.cms.gov/States/03_lowincomesubsidy.asp

Medicare Savings Programs

Medicare Savings Programs are state programs created to help people with low income who qualify to enroll in Medicare to pay for the costs of its coverage. These programs help pay for Medicare premiums. Some programs also help pay for Medicare Part A and Part B deductibles, copayments and coinsurance. These programs are very helpful since many people who qualify to receive Medicare benefits have limited income. Many older adults who are no longer working and disabled individuals incapable of working can benefit from these programs. For more information on these programs, see http://www.mymedicarematters.org/AboutMedicare/mspinfo.php

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