Medicare Extra Help

Medicare Extra Help

Extra Help is a program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance. If you get Extra Help but you’re not sure if you’re paying the right amount, call your drug plan. Your plan may ask you to give information to help them check the level of Extra Help you should get.

Medicare has four basic forms of coverage:

• Part A: Pays for hospitalization costs

• Part B: Pays for physician services, lab and x-ray services, durable medical equipment, and outpatient and other services

• Part C: Medicare Advantage Plan (like an HMO or PPO) offered by private companies approved by Medicare

• Part D: Assists with the cost of prescription drugs including Part D Deductibles and the Coverage Gap.

Medicare enrollees who have limited income and resources may get help paying 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 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).

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, prescription drug coverage costs.

PACE

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

Save on drug costs

Qualify for extra help from Medicare to pay the costs of Medicare prescription drug coverage if you meet certain income and resource limits.