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Get Medicare Extra Help

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Get Medicare Extra Help

Understanding Medicare’s Extra Help Program

The Extra Help program is designed to assist individuals with limited income and resources in covering the costs associated with the Medicare prescription drug program. These costs can include premiums, deductibles, and coinsurance. If you’re currently receiving Extra Help but are uncertain about whether you’re paying the correct amount, it’s recommended to contact your drug plan. They may request additional information from you to verify the level of Extra Help you’re eligible for.

Exploring Medicare’s Extra Help

Extra Help isn’t an insurance policy. Rather, it’s a subsidy that reduces the cost of your drug coverage under Medicare Part D. As a recipient of Extra Help, you’ll receive the same coverage as others on the same plan, but at a reduced cost.

Often referred to as the Part D Low-Income Subsidy (LIS) program, Extra Help was established to support individuals with limited financial means.

Individuals with low income may struggle to cover the various costs associated with Medicare drug coverage, including:

  • Monthly premiums
  • Annual deductibles
  • Prescription pick-up copayments

Coverage Under Extra Help

Depending on your circumstances, Extra Help may cover a portion or all of your drug costs, potentially saving you up to $5,000 annually.

It’s important to note that the Extra Help program only covers costs related to a Medicare prescription drug plan (Part D). It does not provide assistance with costs from other parts of Medicare (Part A, Part B, Part C, or Medicare supplement plans).

For a comprehensive overview of the different parts of Medicare, refer to our Medicare 101 Guide.

One of the benefits of Extra Help is that it waives the late enrollment penalty for not obtaining Part D drug coverage when you were first eligible. However, it does not affect the Part B late-enrollment penalty.

How to apply for extra help

Applying for the Medicare Extra Help program is straightforward. Here are the steps you can follow:

  • Complete the Social Security Application for Extra Help with Medicare Prescription Drug Plan Costs (Form SSA-1020).
  • You can apply online at www.socialsecurity.gov/extrahelp.
    Alternatively, you can call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to apply over the phone or to request an application.
  • You can also schedule an appointment to apply at your local Social Security office.

Please note that the level of help you receive depends on your income and assets, and you’ll need to provide information about your financial situation. The Extra Help assistance does not start until you’re enrolled with an approved Medicare prescription drug provider. If you disagree with the decision made about your eligibility for Extra Help, you can complete an Appeal of Determination for Extra Help with Medicare Prescription Drug Plan costs.

For more information about the Extra Help program, you can visit Medicare.gov.