Questions about Extra Help? SelectQuote has you covered.
Let us help you figure out what extra support you’re qualified for.
Questions about Extra Help? SelectQuote has you covered.
Let us help you figure out what extra support you’re qualified for.
What is Medicare Extra Help?
Medicare Low Income Subsidy—also known as the Medicare Extra Help Program—is meant to help individuals with fixed incomes pay for some if not most of the out-of-pocket costs of Medicare Part D. It’s also known as the Part D Low-Income Subsidy.
It’s important to remember that Extra Help is not a replacement for Part D nor is it a plan on its own. You must still have a Part D plan to receive Medicare prescription drug coverage with Extra Help. However, Medicare Part C—also known as Medicare Advantage—can often include drug coverage in lieu of a stand-alone Part D plan.
Medicare Extra Help Qualifications and Income Limits
Depending on your income and assets, you could qualify for either full or partial Extra Help. Both help with the cost of prescription drugs.
If any of the following are applicable, there is a chance you are automatically qualified for Extra Help and don’t need to apply for the program.
- Are dual-eligible (i.e. enrolled in both Medicaid and Medicare)
- Receive Supplemental Security Income (SSI)
- Qualify for a Medicare Savings Plan
- Are dual-eligible (i.e. enrolled in both Medicaid and Medicare)
- Receive Supplemental Security Income (SSI)
- Qualify for a Medicare Savings Plan
Medicare Extra Help Benefits
The amount of financial support you can receive from Extra Help depends on both your income and resources, but most people who qualify for Extra Help will pay:
- No premiums (up to state benchmark; varies by state)
- No drug deductibles
- No more than $4.15 for generic & $10.35 for brand-name for each drug the plan covers1
- No premiums (up to state benchmark; varies by state)
- No drug deductibles
- No more than $4.15 for generic & $10.35 for brand-name for each drug the plan covers1
Additionally, Extra Help beneficiaries have the following benefits:
- Quarterly Special Enrollment Period – From January-September, you can join or switch Medicare Part D drug plans once every three months. This special enrollment period makes it so you don’t have to wait for the Medicare Advantage & Prescription Drug Plan Annual Enrollment Period (October 15-December 7) to change plans. Any plans made outside of the Medicare Annual Enrollment Period then become valid the following month. This benefit can be especially helpful to those who may need to begin medications that are not on the current plan’s approved drug list.
- No Part D Late Enrollment Penalty – Even if you enroll after you were first eligible to join a Part D plan and did not have other drug coverage.
- Quarterly Special Enrollment Period – From January-September, you can join or switch Medicare Part D drug plans once every three months. This special enrollment period makes it so you don’t have to wait for the Medicare Advantage & Prescription Drug Plan Annual Enrollment Period (October 15-December 7) to change plans. Any plans made outside of the Medicare Annual Enrollment Period then become valid the following month. This benefit can be especially helpful to those who may need to begin medications that are not on the current plan’s approved drug list.
- No Part D Late Enrollment Penalty – Even if you enroll after you were first eligible to join a Part D plan and did not have other drug coverage.
How to Apply for Low Income Subsidy
To apply for Medicare Low Income Subsidy, simply complete an ‘Application for Extra Help with Medicare Prescription Drug Plan Costs’ with Social Security. You can do so by:
- Applying online at www.ssa.gov/benefits/medicare/prescriptionhelp
- Calling Social Security at 1-800-772-1213
- Applying in person at your local Social Security office
- Applying online at www.socialsecurity.gov/prescriptionhelp
- Calling Social Security at 1-800-772-1213
- Applying in person at your local Social Security office
Save on Medicare Costs with SelectQuote
We specialize in helping consumers understand the many pieces of Medicare. We can ensure you’re getting all of the available Medicare benefits you deserve at a price that’s right for your budget, and in just minutes, we can compare all the options available in your area. Get started today—there’s no obligation to enroll.
1https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/find-your-level-of-extra-help-part-d
