|Vol. 14, Issue 7 – April 6, 2015|
How can I qualify for Extra Help?
I have some chronic health care conditions, and have to take several prescription drugs to manage them. I spend a lot of money on Medicare prescription drug copays each month, and I’m struggling to keep up with these costs. My friend told me that I should see if I can apply for the Extra Help program. What is the Extra Help program?
– Barbara (San Francisco, CA)
Extra Help is a federal program that helps people with limited incomes to pay the costs associated with Medicare prescription drug coverage (Medicare Part D). Extra Help is administered by the Social Security Administration. To qualify, you must meet income and asset guidelines that are determined by the federal government each year. If you are single in 2015, your monthly income must be below $1,471 ($1,991 for couples), and your assets must be up to $13,640 ($27,250 for couples) in order to qualify for Extra Help.
In order to have Extra Help, you must get your prescription drug coverage through Medicare Part D. You can get this coverage through a stand-alone Part D plan that works with Original Medicare, or through a Medicare Advantage plan that includes prescription drug coverage. Extra Help does not work with other forms of prescription drug coverage, such as coverage from an employer. If you do not have a Part D plan, Extra Help gives you a Special Enrollment Period to enroll in a Part D plan outside of typical enrollment periods.
Depending on your income and assets, you may qualify for either full or partial Extra Help. With either program, you will never have to pay the full cost of your drugs as long as you take medications that are on your plan’s formulary—its list of covered drugs—and you buy them at a pharmacy in your plan’s network. You also can use a mail-order pharmacy with Extra Help. Extra Help can also assist with your monthly Part D premium and annual deductibles.
Apply for Extra Help through the Social Security Administration. You can call the National Hotline at 800-772-1213, or visit your local Social Security office. You also can apply online at http://www.ssa.gov/medicare/prescriptionhelp/.
If you do not qualify for Extra Help, your state may have a State Pharmaceutical Assistance Program (SPAP) that can assist with prescription drug costs. Eligibility requirements and program benefits may vary, depending on the program. Contact your local State Health Insurance Assistance Program (SHIP) to see if there is one available in your state. To find your SHIP, visit www.shiptacenter.org or call 877-839-2675.
|For some, the start of Spring may mean the start of springtime allergies. Springtime allergies can cause sneezing, watery eyes, runny noses, or itchy eyes or throat. If you experience such allergies, it is important to know what triggers them so that you can take steps to protect yourself. Some tips for reducing the side effects of allergies:
To read about protecting yourself from Spring allergies, click here.
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Dear Marci is a biweekly e-newsletter designed to keep you — people with Medicare, social workers, health care providers and other professionals — in the loop about health care benefits, rights and options for older Americans and people with disabilities.
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