Medicare Extra Help and Considerations

Mother and Daughter talking about how to get extra financial help for Medicare
Is There Extra Financial Help for Medicare? Yes!

Is there financial help for Medicare? There is Extra Help to pay for Part D Drug Plan premiums, drug copays and Medicare premiums for people with limited income and assets. You can apply for Extra Help by calling Social Security at 1-800-772-1213 or by going to www.ssa.gov.

About Low Income Subsidy (LIS)/Extra Help

This extra financial help is called LIS (Low Income Subsidy). To qualify, your income must be less than 150% of Federal Poverty Level. Your assets (money in checking, savings, stocks, bonds, CDs, and IRAs) must be less than the amount in the chart below. You also can’t own any other property other than the home you live in. There are different levels of Extra Help. If you think you might be eligible, it doesn’t hurt to apply.

If you qualify for Extra Help for Medicare, your Prescription Drug Plan or MAPD premium may be reduced and your drug copays will be less. Any level of Extra Help also means you are exempt from the donut hole/coverage gap.

Family Size Income Resources
One Person $1485/month $13,820
Two People $2003/month $27,600
More People $518/month more for each person $27,600

What About Medicare Advantage Plans?

Medicare Advantage plan premiums consist of two components: a health portion and a prescription drug portion. With Extra Help, the prescription drug portion will be reduced. This will reduce your total premium and prescription drug copays. Medical copays are not affected by LIS.

What About Medicaid?

Medicaid is a state program designed to assist those with extremely limited income and assets. If you have Medicare and Full Medicaid you are considered a Dual Eligible Member. If you are on Medicare, you must be at 100% of the Federal Poverty Level (FPL) to qualify for Medicaid. There are different levels of Medicaid. In addition, your resource limit is much lower ($2,000 for an individual). You can apply for Medicaid at the local Medicaid Office.

There are Medicare Advantage plans available for Dual Eligible Members that can give you additional benefits like dental, hearing, vision, over-the-counter allowance, and Silver Sneakers (an exercise program).

Imagine Insurance Advisors – the Helpful People

We know that you need to keep as much of your income as you can when you are on a fixed income. We can help you apply for Extra Help through Social Security. It never hurts to put in an application to see if you qualify. Call us to help you apply this week.

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