Medicare Part D: Things People With Cancer May Want to Know

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Getting help to pay Medicare Part A and/or Part B premiums (the Medicare Savings Programs)

You may be able to get help paying for your Medicare coverage.

Some states have programs that can help you pay for premiums, deductibles, and co-pays. These programs help people with Medicare who have low incomes and limited resources (see note below). The names of the programs and how they work vary from state to state. In most cases, to qualify for one of the Medicare Savings Program in 2014, you must do all of these:

  • Have Medicare Part A
  • If you are single, have monthly income less than $1,313 and resources* less than $7,080
  • If you are married and living together, have monthly income less than $1,765 and resources* less than $10,620
  • Note: These amounts are for 2014 and change each year. Many states figure your income and resources differently, so you may qualify in your state even if your income is higher than listed here.

    *Resources include money in a checking or savings account, stocks, and bonds. Resources don’t include your home, car, burial plot, burial expense accounts up to your state’s limit, furniture, or other household items.

Call or visit your state Medicaid office to get information on Medicaid Savings Programs. Another option is to call the Department of Health and Human Services at 1-877-696-6775. You’ll be asked to enter your area code to be connected to your state. You can also go online at www.medicare.gov/publications to read the brochure called “Get Help With Your Medicare Costs: Getting Started.” Or call 1-800-MEDICARE (1‑800‑633‑4227) to find out if a copy can be mailed to you.

The low-income subsidy or Extra Help

Medicare’s low-income subsidy (LIS) program, also called Extra Help, can help you pay for your prescription drug costs if you have a limited income. Call Social Security to find out if you qualify for this help (contact information is in the “Where can I get more help?” section). You can apply for Extra Help at any time.

If you qualify for Extra Help and join a Medicare drug plan, you will get:

  • Help paying your Medicare drug plan’s monthly premium, yearly deductible, co-insurance, and co-payments
  • No coverage gap
  • No late enrollment penalty

You automatically qualify for Extra Help if you have Medicare and one of these:

  • Full Medicaid coverage
  • You get help from your state Medicaid program paying your Part B premiums (in a Medicare Savings Program)
  • You get Supplemental Security Income (SSI) benefits

If you automatically qualify for Extra Help, Medicare will mail you a purple letter that you should keep for your records.

Some other things you should know about Extra Help:

  • If you aren’t in a Part D plan, you must join one to use the Extra Help.
  • If you qualify for Extra Help and don’t enroll in a Part D plan, Medicare may enroll you in one. If this happens, you will be sent a yellow or green letter telling you about the plan you are enrolled in and when coverage begins.
  • Different plans cover different drugs. Check to see if the plan you are enrolled in covers the drugs you use and the pharmacies you use. You may need to check out other plans in your area.
  • If you’re getting Extra Help, you can switch to another Medicare drug plan anytime – not just during open enrollment. Your coverage will be effective the first day of the next month.
  • If you get a letter from Medicare saying you no longer automatically qualify for Extra Help, you can reapply by calling Social Security.

Last Medical Review: 01/22/2014
Last Revised: 01/23/2014