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Medicare "Extra Help" provides help paying for the costs of Medicare Part D for people with limited income and assets.

Extra Help is easy to apply for. You can apply for Extra Help at any time

Eligibility lasts for a full year. For example, if you request Extra Help in February of one year, it lasts until February of the next year.

Elibgibility requires that you have limited income and assets. The dollar amounts vary from year to year.   

  • If you have a Medicare Savings Program (QI-1, SLMB, or QMB), or receive Supplemental Security Income (SSI), you automatically qualify for Extra Help.
  • Assets include bank accounts, investments, cash value in life insurance policies and real estate other than your home. Cars, funeral expenses up to $1,500, personal property are also excluded.
  • To learn current income and asset requirements, call 800-MEDICARE (800.633.4227)
  • Before you apply for Extra Help, do the math. If your income is low enough to qualify for a drug companies' patient-assistance program but not low enough to qualify for the full Extra Help subsidy, you may be better off skipping Part D and getting free prescription medications from the manufacturers.

If you qualify and:

  • Are already enrolled in a Part D Plan: Medicare will notify the Plan. The Plan will reduce your costs appropriately. You don't have to do it.
  • Not yet enrolled in a Drug Plan, you can enroll when you qualify, even though it is outside a normal period. If you don't enroll after asking for Extra Help, you will automatically be enrolled in a Plan.

With Extra Help, you can change Drug Plans once a month. While this is your right, it is not necessarily a good thing to do. Constant changes increases chances something will go wrong with coverage.

If You Receive Medicaid Or Supplemental Security Income, Or If Your State Pays Your Medicare Premiums

  • You automaticdally qualify for Extra Help.
  • You pay no premium or deductible.
  • Your copays for each prescription are limited to $1 or $2 for generics and $3 or $5 for brand drugs
  • You pay nothing for drugs in the catastrophic area

If You Are In A Nursing Home

Drugs may be covered as part of the nursing home costs. If that is the case, you may pay nothing for drugs.

For information about how to apply for Extra Help, click here

How To Apply For Extra Help

If you have a Medicare Savings Plan or Medicaid, or Supplemental Security Income, you will get a letter from Medicare stating that you are automatically eligible for Extra Help. If you automatically qualify for Extra Help, Medicare will automatically enroll you in a drug plan unless you choose one yourself. (To learn how to choose a Drug Plan yourself, see :Part D -- How To Choose.) If you don't get a letter saying you are automatically enrolled,  you have to apply.

If you don't automatically get Extra Help, you must contact Social Security Administration and fill out an application. You can complete an application on line or over the telephone by calling 800.772.1213 or at your local Social Security office. You don't have to provide proof of income or assets -- but expect that Medicare will check.

If your application is denied, you can appeal. Instructions about how to appeal are included in the denial letter.

Once enrolled for Extra help, it renews automatically, subject to a check by Social Security ("Redetermination"). It is advisable to respond to any requests for information from Social Security within the time limit stated. It doesn't matter that the facts of your situation may not have changed.(If you need more time than requested by Social Security, go to your local Social Security office and ask for another 30 days.)

If you enrolled yourself in Medicare Part D, and then receive Extra Help, the plan must reimburse you for the costs.

For questions about Extra Help, see: offsite link or call 800.772.1213

For questions about Medicare, go to the Medicare Rights Center: offsite link