The Medicare Extra Help Program is through Medicare Part D. This program is designed to help those with low-income or limited resources. The federal government decides if you qualify for Extra Help through Part D, and if so, then you can receive help with premiums, deductibles, and coinsurance. By speaking with our team at Cornerstone Senior Advisors, we can help further explain and guide you in the right direction as to how to handle finding if you qualify.
Documentation
Documentation is required in order to receive Extra Help with Medicare Part D. Examples of the proper qualifications include:
- Deemed Status Notice: A purple letter from Medicare stating that you automatically qualify. If you receive this letter, you have both Medicare and Medicaid, are in a Medicare Savings Program, or receive Supplemental Security Income (SSI) benefits.
- Automatic Enrollment Notice: A yellow notice from Medicare stating you automatically qualify for Extra Help because are eligible for Medicare and Medicaid and currently receive benefits through Original Medicare. Medicare will automatically enroll you into a drug program unless you decline enrollment or join a plan on your own.
- An Extra Help “Notice of Award” from Social Security: This award is received in mid-May, and explains the Medicare Savings Program (MSP) and Extra Help available for Medicare prescription drug coverage. If this Notice of Award is received, you must apply for Extra Help through the Social Security office or Medicaid office.
- Change Extra Help Copayment Notice: You will receive this orange notice from Medicare in October if Social Security deems that you are still eligible for Extra Help, but you will have a different level of copays in the following year.
- If you receive Supplemental Security Income (SSI), then you may present your letter from Social Security stating you have SSI.
You may also show proof you have Medicaid and live in an institution or get home- and community-based benefits, or other documentation that you receive Medicaid, such as your Medicaid card or state documentation proving you receive Medicaid.
How To Apply For Extra Help
You can apply for Extra Help through the Social Security Administration if you don’t receive Supplemental Security Income (SSI), Medicaid, or a Medicare Savings Program (MSP). Your state may even screen you for a Medicare Savings Program at the time of application. It is imperative to remember that Extra Help helps cover prescription drug costs that are already covered through your Medicare Part D drug plan.
Suppose you receive Extra Help but do not enroll in a Medicare Part D plan. In that case, you will be automatically enrolled in a “benchmark Part D plan.” A benchmark plan has a premium lower than your state’s normal amount, meaning Extra Help pays 100% of your prescription drug cost premium that is covered under your plan. You will receive a notice from Medicare explaining your benefits and what they mean.
If you need more guidance or have questions on where to start with Medicare Part D, give Cornerstone Senior Advisors a call today!