Medicare offers a program called Extra Help for participants of modest means. Extra Help offers support for monthly premiums, annual deductibles and co-payments related to prescription drug coverage, commonly known as Medicare Part D.
How do I qualify for Medicare Extra Help?
Qualifying for Extra Help will lower the cost of your prescription drugs and your Prescription Drug Plan or Medicare Advantage Plan premium.
Qualifying for Extra Help is simple:
- You must be receiving Medicare;
- You must have limited resources and income;
- You must reside in one of the 50 states or the District of Columbia.
Income limits for in 2021 were $19,140 for an individual and $25,860 for a married couple living together. When your income is calculated, governmental assistance such as food stamps, housing assistance, and home energy assistance are not counted. You may also qualify if you earn more than that and support family members who live with you.
Medicare also counts your resources, like money in the bank, investments and real estate you own, to determine your eligibility for Extra Help. Your resources cannot exceed $14,610 as an individual or $29,160 as a married couple living together to be eligible. That does not include your vehicles or primary residence.
The Importance of a Medicare Advantage Plan
Under Extra Help, it is important for you to choose the drug plan that works for you, otherwise Medicare will automatically enroll you in a Prescription Drug Plan.
This is not in your best interest.
A full Medicare Advantage Plan is better than a standalone Prescription Drug Plan because it covers more drugs and provides extra benefits like dental, vision, and much more. In most cases, the Medicare Advantage Plan is less expensive than a Prescription Drug Plan and provides more benefits.
That’s right:
A full Medicare Advantage Plan provides more benefits than a Prescription Drug Plan.
A full Medicare Advantage Plan is less expensive than a Prescription Drug Plan.
Let’s put this simply:
- Extra Help is great!
- Choose your own Prescription Drug Plan to save money and get added benefits.
- Don’t let Medicare automatically enroll you in whatever Prescription Drug Plan it chooses.
Let’s look at an example of how this might work:
Let’s say you and your spouse living here in South Carolina are receiving Medicare and have combined income of $24,000. You likely qualify for Extra Help. That is true whether you live in Charleston, Mt. Pleasant, North Charleston, Summerville, James Island, Johns Island, Goose Creek or anywhere else in the state.
You contact me because you know that as a licensed SC Medicare Enrollment Plan Specialist, I know all the ins and outs of Medicare and can help you determine the best plans for your specific needs.
And you know that my help won’t cost you a penny.
We enroll you in Extra Help and choose the full Medicare Advantage Plan. Most Medicare Advantage Plans include a Prescription Drug Plan. As Medicare acknowledges, these plans can be complex. Consider what Medicare says:
“In many cases, you’ll need to use health care providers who participate in the plan’s network and service area for the lowest costs. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services, to help protect you from unexpected costs. Some plans offer out-of-network coverage, but sometimes at a higher cost.”
It’s a good thing I am working as your guide!
How do I Enroll in Extra Help?
Medicare encourages you to apply for Extra Help online, and when you do, it will ask you a series of questions to determine whether you qualify for Extra Help.
Before you attempt to answer these questions, you will want to gather documents like bank account information, and determine the value of benefits you receive and investments you may have. It can be complicated, but I can help you navigate those questions and move through the enrollment process.
If you think you might qualify, it is definitely worthwhile to apply for Extra Help. Social Security estimates it is worth about $5,000 per year, on average. It may save you a little more or less, depending on your particular circumstances. But in any case, let’s work together and save you money.