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How To Get Medicare Extra Help

Medicare Made Easy

How To Get Medicare Extra Help

Anyone who has Medicare can get Medicare prescription drug coverage. Some people with limited resources and income also may be able to get Extra Help with the costs — monthly premiums, annual deductibles, and prescription co-payments — related to a Medicare prescription drug plan. The Extra Help is estimated to be worth about $5,000 per year. Many people qualify for these big savings and don’t even know it. To find out if you qualify, Social Security will need to know the value of your savings, investments, real estate (other than your home), and your income. We need information about you and your spouse if you are married and living together.

To help Social Security determine if you are eligible for Extra Help, you will need to file an Application for Extra Help with Medicare Prescription Drug Plan Costs (Form SSA-1020).

Medicare Extra Help

Extra Help is a federal program that helps pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage. It is also known as the Part D Low-Income Subsidy (LIS).        

Medicare enrollees who have limited income and resources may get help to pay for their premiums and out-of-pocket medical expenses from Medicaid (e.g., MSPs, QMBs, SLBs, and QIs).

Medicaid also covers additional services beyond those provided under Medicare, including nursing facility care beyond the 100-day limit or skilled nursing facility care that Medicare covers, prescription drugs, eyeglasses, and hearing aids. Services covered by both programs are first paid for by Medicare with Medicaid filling in the difference up to the state’s payment limit.

There are special Medicare Advantage Plans Called Dual Eligible Plans for individuals who qualify for both Medicare and Extra Help (Medicaid).

Get help paying costs

 

Medicaid

Medicaid is a joint federal/state program that helps with medical costs for some people with limited income and resources.

Medicare Savings Programs

State Medicare Savings Programs (MSP) programs help pay premiums, deductibles, coinsurance, copayments, and prescription drug coverage costs.

PACE

PACE (Program of All-inclusive Care for the Elderly) is a Medicare/Medicaid program that helps people meet healthcare needs in the community.

Lower prescription costs

Qualify for extra help from Medicare to pay the costs of Medicare prescription drug coverage (Part D). You’ll need to meet certain income and resource limits.

Find your level of Extra Help (Part D)

Information on how to find your level of Extra Help for Medicare prescription drug coverage (Part D).

Insure Kids Now

The Children’s Health Insurance Program (CHIP) provides free or low-cost health coverage for more than 7 million children up to age 19. CHIP covers U.S. citizens and eligible immigrants.

Supplemental Security Income (SSI)

A monthly benefit paid by Social Security. SSI is for people with limited income and resources who are disabled, blind, or age 65 or older. SSI benefits aren’t the same as Social Security retirement or disability benefits.