Have you heard about Medicare’s Extra Help program?
Extra Help is a government program designed to help cover the cost of Medicare Part D (Prescription Drug Plan) – including premiums, deductibles, and coinsurance – for people with low income or limited resources.
Most people who qualify for Extra Help are either unaware of the program or don’t realize they are eligible for additional drug coverage. Since state governments distribute Extra Help coverage, individuals must meet the financial criteria set by the government in order to qualify.
While specific savings can vary based on coverage benefits and an individual’s health care needs, the Social Security Administration estimates that Extra Help beneficiaries can save roughly $5,100 per year.
Who Qualifies for Extra Help?
Qualifying for Extra Help can come about in one of two ways:
Existing enrollment in a Medicare Savings Programs
If an individual is receiving support for health care costs through Medicare Savings Programs they may be automatically enrolled in Extra Help. There are three different Medicare Savings Programs:
- Specified Low-Income Medicare Beneficiary (SLMB) Program
- Qualified Medicare Beneficiary (QMB) Program
- Qualifying Individual (QI) Program
Low income and/or limited resource status
Individuals who fall below the government’s predetermined level of income or resources can meet Medicare Part D eligibility for Extra Help. Just know, the qualifying income and resource limits differ based on whether someone is single or married.
When evaluating an individual’s resources, the government takes into account money held in a checking or savings account as well as stocks and bonds. It does not, however, look at assets such as a home, car, household items, or savings for burial costs.
For 2022, Extra Help annual income and resources limits are:
- Married (Living With Spouse): $30,950
- Single (Not Married or Living With Spouse): $15,510
Levels of Extra Help Coverage
Individuals who receive Extra Help will notice there are different levels of drug coverage that can impact how much they pay at the pharmacy counter. Be sure to consult your prescription drug plan provider to ensure you are paying the correct amount for your Medicare Part D coverage.
Anticipated Costs of Prescription Drugs
Wondering what Medicare Part D covers through Help Extra? With Extra Help, Medicare beneficiaries can expect to pay no more than the Low Income Subsidy (LIS) drug coverage costs for each prescription. The most recent prices for generic drugs were $3.70 and $9.20 for brand-name drugs.
Enrolling in Medicare Part D and Extra Help
Not sure if you qualify for Extra Help? We can help. Medicare Choice Group’s team of experts can check your eligibility and enrollment status.
We can also walk you through the application process, assess your Medicare Part D eligibility, and ensure you are making the most of your Medicare benefits.
Connect with Medicare Choice Group online or give us a call at (855) 482-0574.
