Getting Medicare? Do You Qualify for Help Paying for Prescriptions?

Extra Help? Part D? Low-Income Subsidy? Prescriptions?

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Medicare prescription coverage is called Part D and if you are enrolling in Medicare, you have to enroll in Part D to get prescription coverage. Medicare can help you pay for some or all of your out of pocket prescription costs through a program called Extra Help or the Part D Low-Income Subsidy.

What is Extra Help?

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Extra Help provides a Low-Income Subsidy to help pay for out of pocket costs for Part D prescription plans. Extra Help will help pay for monthly premiums, annual deductibles and prescription co-payments. Extra Help can save you up to $4900 a year depending on your medications and on your income and assets. If you have low assets and are working, you may qualify even if your income is over the limit below. If you are struggling to pay for prescriptions, apply.

To qualify for Extra Help, your income and assets must be below:

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How do I get Extra Help?

You must apply for Extra Help, it is not usually automatic. Social Security will need information about your income and assets. Assets include your savings, investments and real estate (other than your home). If you are married, you will need information for yourself and your spouse.

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You may have received an Extra Help application in the mail when you first received information about starting Medicare. If you filled it out and mailed it back, you have already applied. If not, you can apply online at SocialSecurity.gov.

Some people automatically qualify for Extra Help and will receive a notice from Medicare. The notice will be purple, yellow or green or possibly orange. The purple notice says you qualify for Medicaid and Medicare and will receive the maximum Extra Help benefit. The yellow notice indicates you qualify for Extra Help and have been auto-enrolled unless you are already enrolled in a Part D plan. The orange notice states your Extra Help amount is changing for the coming year.

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How do I know if I already have Extra Help?

You can call Medicare at 1-800-633-4227 or log in to your account at medicare.gov.

In addition to Extra Help with Part D, you may also be eligible for help paying your Part B premium or be eligible for Medicaid with your Medicare.

At the WHP office, we help people who have Medicare apply for Medicaid. We can help you get an appointment with a Medicare Medicaid Assistance Program (MMAP) counselor to choose your Part D prescription plan. If you have questions, call us at 734-544-3030.


Resources:

Medicare 1-800-MEDICARE (1-800-633-4227)

Social Security Administration 1-800-772-1213

Find your Level of Extra Help (Part D) from Medicare.gov.

Understanding the Extra Help With Your Medicare Prescription Drug Plan from Social Security.

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