Medicare Extra Help with Prescription Drugs - HealthPocket

Medicare Extra Help with Prescription Drugs

What is Medicare Extra Help?

Eligible Medicare beneficiaries with limited income can receive “extra help” or assistance with prescription drug costs (about $5,000 annually) associated with their Medicare prescription drug plan This program, also known as the Low Income Subsidy (LIS), can reduce or eliminate the premium and deductible for Medicare prescription drug coverage, depending on the individual’s economic qualifications.1

Qualifying for Medicare Prescription Drug Assistance

In order to receive Extra Help with prescription drug costs, you must meet the following criteria:2

  • Have Medicare Part A and/or Part B
  • Must reside in the US
  • Your resources must not exceed $14,610 if single or $29,160 if married

You automatically qualify for the Extra Help program if you are enrolled in Medicaid or a Medicare Savings Program. You also qualify if you receive Supplement Security Income (SSI) payments.

Determining Your Level of Extra Help

In order to see what assistance you’ll receive, you’ll need to send to your Medicare plan some form of documentation indicating you qualify for Extra Help.3 Examples include:

  • A notice from Medicare or Social Security indicating you qualify.
  • A letter from Social Security indicating you receive Supplemental Security Income.
  • A document from your state that shows you have Medicaid and are getting home and community-based services.
  • A copy of your Medicaid card or documentation from the state indicating you receive Medicaid.

Save on drug costs

In 2020, if you qualify for the full Extra help, you will pay no more than $3.60 for each generic/$8.95 for each brand-name covered drug.4



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