“Extra Help” Is Just That: How Medicare Enrollees Can Save on Prescription Costs

For individuals who are currently enrolled or planning to sign up for Medicare, Extra Help can help cover the cost of prescription drugs.

Seventy percent of people who qualify for Extra Help don’t even realize that they are eligible. Continue reading to learn more about Extra Help and how it can benefit Medicare beneficiaries.

What Is Extra Help? 

Extra Help is a government program designed to help individuals—specifically those with low income or limited resources—pay for Medicare Part D. Medicare Part D covers prescription drugs.

The Extra Help program can help with the cost of premiums, deductibles, and coinsurance for a Medicare prescription drug plan. Coverage varies, but the Social Security Administration estimates that it’s worth about $5,000 in savings each year.

State governments distribute Extra Help coverage. However, individuals must meet the federal government’s financial criteria to qualify. Limits on annual income and available resources determine if someone is eligible.

How Can I Qualify for Extra Help?

There are two ways to qualify for Extra Help. Someone may be automatically enrolled as part of a Medicare Savings Program. If a beneficiary receives support with health care costs through any of these three programs, they also receive Extra Help:

  • Qualified Medicare Beneficiary (QMB) Program
  • Specified Low-Income Medicare Beneficiary (SLMB) Program
  • Qualifying Individual (QI) Program

Medicare Savings Programs aren’t the only way to get Extra Help. If an individual falls below a certain level of income and resources, they can also qualify. The qualifying income and resource limits differ based on whether someone is single or married.

When the government looks at resources, it considers money held in a checking or savings account, bonds, and stocks. It does not factor in assets like a car, home, furniture, household items, burial plots, or savings for burial costs (up to $1,500).

Below are the Extra Help annual income and resource limits for 2021.

  • Single (Not Married or Living With Spouse): $14,790
  • Married (Living With Spouse): $29,520

Not sure if you qualify? Our advisors can help.

Checking Your Level of Coverage

If you get Extra Help, there are different levels of coverage that can impact how much you pay at the pharmacy. To make sure you’re paying the right amount for Medicare Part D, your prescription drug plan provider can check your level of coverage. Se

Expected Costs for Prescriptions With Extra Help

You will pay no more than the Low Income Subsidy (LIS) drug coverage cost for each of your prescriptions. In 2021, that was $3.70 for generic drugs and $9.20 for brand-name drugs.

How to Enroll

In many cases, individuals are automatically enrolled in Extra Help. However, if you or someone you know is interested in applying for Extra Help, our advisors can assist! RetireMEDiQ has a dedicated team that can check your level of Extra Help coverage, can help you apply, and show you how to make the most of your benefits. Contact us today for a no-cost review of your situation.

Your Local Experts in Medicare

If you have questions about Extra Help, Medicare Part D, or how to find the right benefits, RetireMEDiQ is ready to help. To request information about RetireMEDiQ, call 1-866-921-6468 or email [email protected].

If you are already a RetireMEDiQ client, you can contact your advisor by calling 1-877-222-1942 or emailing [email protected].

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