Making an Extra Help decision when you have other forms of prescription drug coverage If you do not choose a plan, you will in most cases be automatically enrolled in one. Remember that Extra Help is not a replacement for Part D or a plan on its own: You must still have a Part D plan to receive Medicare prescription drug coverage and Extra Help assistance. To receive such assistance, your prescriptions should be on your plan’s formulary and you should use pharmacies in your plan’s network. Both programs provide assistance with the cost of your drugs. Eliminates any Part D late enrollment penalty you may have incurred if you delayed Part D enrollmentĭepending on your income and assets, you may qualify for either full or partial Extra Help.You should use Fall Open Enrollment during this time to make prescription drug coverage changes.) Gives you a Special Enrollment Period (SEP) once per calendar quarter during the first nine months of the year to enroll in a Part D plan or to switch between plans (You cannot use the Extra Help SEP during the fourth calendar quarter of the year (October through December).Lowers the cost of your prescription drugs.Pays for your Part D premium up to a state-specific benchmark amount.The Extra Help program (also called the Part D Low-Income Subsidy) offers the following benefits: You should receive a purple-colored notice from the Centers for Medicare & Medicaid Services (CMS) informing you that you do not need to apply for Extra Help. If you are enrolled in Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program (MSP), you automatically qualify for Extra Help regardless of whether you meet Extra Help’s eligibility requirements.These limits include a $20 income disregard that the Social Security Administration (SSA) automatically subtracts from your monthly unearned income (e.g., retirement income).Įven if your income or assets are above the eligibility limits, you could still qualify for Extra Help because certain types of income and assets may not be counted, in addition to the $20 mentioned above. If your monthly income is up to $1,843 in 2023 ($2,485 for couples) and your assets are below specified limits, you may be eligible for Extra Help (see the Extra Help income and asset limit chart for details).It is also known as the Part D Low-Income Subsidy (LIS). Extra Help is a federal program that helps pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage.
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