Extra Help Paying for your Prescriptions

Many Medicare beneficiaries find that their largest out-of-pocket cost for their healthcare is their monthly prescription costs, especially for people with chronic illnesses such as chronic obstructive pulmonary disorder (COPD), diabetes, or fibromyalgia. Many of the prescription drugs for these illnesses and others like it can be very expensive.


If you or someone you know takes a lot of prescriptions and has trouble affording them, you may be able to get help paying your Medicare drug costs with a program called Extra Help. Also called the Part D low-income subsidy or LIS, Extra Help is a Federal program that helps people with limited income and resources pay for their Part D premiums and drug costs.


Most people who qualify for Extra Help will pay:


  • No premiums,
  • No deductibles, and
  • No more than $3.30 for generic drugs and $8.25 for brand names drugs in 2017 for each drug their plan covers.


Those who qualify for Extra Help will not be subject to the Part D Coverage Gap or “Donut Hole.”


The amount of Extra Help you get depends on your income and resources. If you qualify for Extra Help, you can join a Medicare Part D or Medicare Advantage plan at any time and will not have to pay a penalty, even if you enroll late.


So who qualifies for Extra Help? There are different levels of Extra Help available, depending on your income and assets. People with a lower income and fewer assets get more help with their Medicare drug plan costs. You may qualify if your total annual assets and income are less than $27,600 if you are married, or $13,820 if you are single. You do NOT count your home, vehicles, personal possessions, life insurance, burial plots, irrevocable burial contracts or back payments from Social Security or SSI when calculating your total assets and income.


If you think you may qualify for Extra Help and would like to apply, you can get started here at the Social Security Administration website.   You can also speak with one of our licensed agents at 1-844-680-7855 if you have more questions or would like assistance applying for Extra Help.

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