- The Medicare prescription drug coverage: Part D
- Special things people with cancer need to think about
- Who should enroll in Medicare Part D?
- Making a Part D plan decision
- Getting help to pay Medicare Part A and/or Part B premiums (the Medicare Savings Programs)
- Formularies and drug coverage
- Where can I use my Part D drug coverage to fill my prescriptions?
- How much will the Part D drug plan cost?
- Things to know once you’ve chosen a Part D drug plan
- Switching drug plans in the future
- Frequently asked questions
- Where can I get more help?
- Are you ready to get started?
- More information from your American Cancer Society
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, you must do all of these:
- Have Medicare Part A
- If you are single, have monthly income less than $1,277 and resources less than $6,940
- If you are married and living together, have monthly income less than $1,723 and resources less than $10,410
Note: These amounts are for 2013 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. You can get the phone number by calling 1-800-MEDICARE (1-800-633-4227) and following the voicemail prompts (you may have to ask for other choices, limited income, and other Medicare costs). 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 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: 10/26/2012
Last Revised: 10/26/2012