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Benefits Breakdown: How Can I Get Up to $5,100 in Medicare Extra Help?

Posted on May 31, 2022 by Larry Johnson

Could you use the Medicare Extra Help benefit to help you cut costs? Our experienced, licensed agents can help you learn more about this crucial benefit. Give us a call today at (800) 950-0608 for more information.

Certain Medicare Plans Can Provide You With Some Assistance in Paying for Your Part D Prescription Drug Plan

Some of the extra benefits that can come with Medicare Advantage plans are also some of the best-kept secrets in the world of Medicare. From premium reductions to extra financial assistance with prescription drugs, our Benefits Breakdown series aims to uncover some of the ways that enrolling in a Medicare Advantage plan can help you save money.

For instance, you may not have realized that certain Medicare Advantage plans provide a way to save on costs related to your Medicare Part D plan. From assistance with Medicare prescription plan monthly premiums to help with co-payments for your prescriptions, the Medicare Extra Help program offers several ways to help you manage costs for much-needed medications.

Our Benefits Breakdown blog series is designed to highlight some of the helpful benefits that can come with Medicare Advantage (Part C) plans. Today, we’ll be discussing the $5,100 Medicare Extra Help benefit.

What is the Medicare Extra Help Benefit?

It’s well known that many seniors live on a fixed income. This can make it difficult to choose between paying utilities, buying groceries, or buying medications from month to month. Both Medicare Advantage plan providers and the federal government recognized that something needed to be done to help Medicare enrollees have access to needed medications. As a result, the Medicare Extra Help program was born.

Medicare Extra Help is designed to help alleviate costs associated with the Medicare Part D plan for low-income individuals. The program, also known as Social Security Extra Help, is designed to help reduce the cost of:

  • Monthly premiums of Medicare prescription plans
  • Annual deductibles
  • Co-payments for prescription drugs

The Social Security Administration estimates that they are able to provide around $5,100 per year in Medicare Part D plan relief for eligible individuals.

How Do I Qualify for Medicare Extra Help?

In order to qualify for assistance, you must:

  • Be a current recipient of Medicare benefits
  • Have limited financial resources and be able to qualify as “low income”
  • Reside in one of the 50 continental U.S. states or the District of Columbia

Some enrollees of Medicare prescription plans may already qualify and be automatically enrolled. For instance, you will find yourself enrolled automatically in the Medicare Extra Help benefit program if:

  • You are currently enrolled in both Medicare and Medicaid
  • You currently receive Supplemental Security Income (SSI)
  • You qualify for a Medicare Savings Program

In order to qualify as “low income,” you must meet certain income and resource requirements. As of 2021, a single individual must make less than $19,320 per year to qualify ($26,130 for married couples). You must also own less than $14,790 in resources ($29,520 for married couples). The following three resources count toward your qualification status:

  • Available money in checking or savings accounts
  • Stocks
  • Bonds

I Don’t Think I Qualify, But I Still Need Assistance. What Can I Do?

If you don’t meet the qualifying criteria to receive payment assistance for your Medicare Part D plan through Medicare Extra Help, you still have options. You may be eligible for state-run programs that can help you cover the costs of prescription medications. If you feel that you need assistance, contact your local Medicaid office or your State Health Insurance Assistance Program (SHIP) to learn more.

Also, you may still qualify for Medicare Extra Help if your income or resources change in the future. If your income or resources change enough to meet the low income threshold, you can reapply for Extra Help at any time.

I Think I Qualify for Medicare Extra Help. How Do I Apply?

If you qualify, you can apply online through the Social Security Administration. You can also:

  • Call 1(800) 772-1213 (or TTY 1(800) 325-0778) to apply by phone
  • Request a paper application
  • Schedule an appointment to apply in person at your local Social Security office

Find a Medicare Part D Prescription Drug Plan Today

Although you may meet the qualifying criteria for Extra Help, if you aren’t currently enrolled in a Medicare Part D plan, you won’t start receiving assistance until you enroll in an approved Medicare prescription plan. If you need to enroll in a Medicare Part D plan, a Medicare Part D plan finder can help you find approved plans in your area. In fact, we can help – enter your zip code into our Medicare Part D plan finder below to find Medicare Part D plans in your area today.

About the Author

Larry Johnson

Larry is a content writer with several years of experience in creating informative content for a variety of industries on topics that matter. He is a 2009 graduate of the University of North Carolina School of the Arts.

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