If you are struggling paying your Part D prescription drug costs, you may qualify for a program called Extra Help.
Extra Help assists in paying the prescription costs, premiums, deductibles, and coinsurance of Medicare prescription drug coverage.
To qualify, you have to meet certain income and resource limits.
How to qualify for Extra Help
In 2020, you may qualify for Extra Help if you make $19,140 or less in yearly income ($25,860 for a married couple) and $14,610 in resources or less ($29,160 for a married couple).
Per Medicare.gov, Countable resources include:
- Money in a checking or savings account
Countable resources DO NOT include:
- Your home
- One car
- Burial plot
- Up to $1,500 for burial expenses if you have put that money aside
- Other household and personal items
If you already have full Medicaid coverage, get help from Medicaid to pay for your Part B premium, or get Supplemental Security Income benefits, you are automatically eligible for Extra Help.
How much are prescription costs with Extra Help?
In 2020, Part D prescription costs under Extra Help are no more than $3.60 for each generic medication or $8.95 for each brand-name covered drug.
Additionally, there are certain circumstances that will lower your Part D premium and deductible to $0.
What you need to apply
You qualify for Extra Help and do not need to apply if you receive full Medicaid benefits, are enrolled in a Medicare Savings Program, or you receive Supplemental Security Income benefits.
Otherwise, you’ll need to apply for Medicare Extra Help by calling the Social Security Administration at 1-800-722-1213, apply through their website, or by contacting your local Social Security office.
Once you’re enrolled in Extra Help, you’ll need to provide your Part D insurer with documentation.
The following will suffice as proof:
- Your notice of automatic qualification from Medicare
- The Extra Help award notice from the SSA
- Your Supplemental Security Income award letter
- A copy of your Medicaid card