The Benefits of Chronic Condition Plans with Extra Help

Do you have a chronic illness and modest income that qualifies you for Extra Help from Medicare? I advise my clients in this situation to get Chronic Conditions Plans.

Chronic Condition Plans for Medicare beneficiaries who qualify for Extra Help are superior to regular Medicare Advantage Plans.

Here’s why:

With Extra Help, the Federal Government is paying the lion’s share of your prescription drug costs and part of your Medicare Advantage Plan premium.

The money your Medicare Plan provider receives for your enrollment can be spent on more extra benefits, like Dental, Vision, and Over-the-Counter catalog benefits.

The average Medicare Advantage plan has 3 parts: Medical, Prescription, and Extra Benefits such a as vision and dental. Medical refers to hospitalization and services from doctors and other health care providers, outpatient care, home health care, medical equipment and some preventive services.

The chart below demonstrates where a regular Medicare Advantage Plan would invest in benefits.

Regular Medicare Advantage Plan

In contrast, the chart below demonstrates how benefits are invested in a plan catering to those with Extra Help and a chronic condition such as diabetes or congestive heart failure.

Chronic Plans for Those with Extra Help

As you can see, a Chronic Conditions Plan with Extra Help covers medical and prescription drug benefits, just as a regular Medicare Advantage Plan does. Then it goes even further, providing extra benefits like dental, vision and other services.

You get more with a Chronic Condition Plan if you’re eligible for Extra Help.

Let’s look at an example:

Don lives in Goose Creek, SC and has diabetes. He is 68 years old and lives on Social Security and a small pension from when he worked in the 1980s at the Ports Authority.

Because Don has diabetes, he qualifies for a Chronic Condition Plan. Because his income is modes, he qualifies for Extra Help. He gets help with Medicare Part A, B and D (that is, medical, hospital and prescription drugs) premiums, deductibles and co-pays, saving him thousands of dollars each year.

In addition, the Chronic Conditions Plan helps him secure equipment to treat his diabetes, like a blood sugar monitor and test strips, for free.

Qualifying conditions for a Chronic Conditions Plan Include:

• Diabetes
• Congestive Heart Failure
• Cardiac Arrhythmias (irregular heartbeat)
• Coronary Artery Disease (blockage in arteries)
• Peripheral Vascular Disease (circulatory condition that causes pain and blockage of blood flow in legs)
• Chronic Venous Thromboembolic Disorder (blood clot, usually in legs)

What if I no longer take oral medication or insulin for my diabetes?

It doesn’t matter; you are still considered diabetic even if you are able to control your condition with diet and exercise. You will be asked if you have ever had diabetes, not whether you have it now. As long as you can answer “yes,” you can get on a chronic condition plan.

What if I had congestive heart failure a long time ago but I am OK now?

You still qualify. Again, as long as you have ever had congestive heart failure, you can get on a chronic condition plan. These plans are even better if you qualify for extra help.

Medicare is complicated. There were 530 different South Carolina Medicare Advantage plans in 2019. If you have questions about whether you qualify for a Chronic Conditions Plan, or what plans you should enroll in, or how to enroll, call me at 843-245-7313 so I can guide you through the process and help you enroll in the plans that fit your life.

Remember, my services are totally free to you.