Medicare Financial 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

About Low Income Subsidy (LIS)/Extra Help for Prescriptions

This financial help is called LIS (Low Income Subsidy) or Extra Help. To qualify, your gross 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. 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 will be reduced and your drug copays will be less. Also if you have Extra Help, the donut hole does not apply to you; your costs remain level all year.

Family Size Income Resources
One Person $1,883/month $15,720
Two People $2,555/month $31,360

How does it affect my Medicare Advantage Plan?

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 (like at the doctor, tests, surgery, therapy, etc) are not affected by Extra Help and will not change.

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. To be Dual Eligible, you must be at 100% or lower of the Federal Poverty Level (FPL.) There are different levels of Medicaid. Not all levels pay all of your costs; Partial levels may only pay your Part B premium.  The resource limit (money in checking, saving, stock, bond, CD, IRA) is much lower ($2,000 for an individual). You can apply for Medicaid at your local Medicaid Office or through DCBS (Department for Community Based Services.)

There are Medicare Advantage plans designed for Dual-Eligible beneficiaries that can give you additional benefits like even more dental, hearing, vision, higher over-the-counter allowance, and groceries. These plans are called D-SNPs and work to support all the areas that support your health at a greater level than a regular MAPD.

Imagine Insurance Advisors – Helpful People

We know that you need to keep as much of your money as you can when you are on a fixed income. We can help you apply for Extra Help through Social Security. If you are eligible, it can keep even more of your dollars in your pocket. Call us to help you apply this week.