Medicare is meant to be health insurance for all seniors 65 and over, as well as those who are disabled and individuals afflicted with certain conditions. This program also takes income into account, as seen with Medicare Extra Help, which offers assistance for Medicare Part D costs.
What Is Medicare Extra Help?
Medicare Extra Help assists individuals in paying Part D premiums and deductibles.Some can be enrolled automatically, whereas others may have to apply.
What Are The Income Requirements?
Medicare Extra Help has limits on annual income and resources (amount of money in retirement, savings and checking accounts, stocks, and bonds).
Individuals can have no more than:
- $21,870 in income
- $16,600 in resources
Married couples can have no more than:
- $29,580 in income
- $33,240 in resources
Who Gets Medicare Extra Help Automatically?
If one of the following criteria applies, you’ll get Extra Help automatically if you get:
- Supplemental Security Income (SSI) from Social Security
- Full Medicaid benefits
- Help paying Part B premiums from a Medicare Savings Program (MSP)
How Does Extra Help Work?
These are the different levels of Extra Help and the percentage of the plan premium cost you’d pay based on level of Extra Help:
- Level 1 – 25%
- Level 2 – 50%
- Level 3 – 75%
- Level 4 – $0
For the first three levels:
- The deductible doesn’t exceed $104
- Coinsurance costs are capped at 15% of the cost for each covered medication
- Once you and your plan have paid $7,400 for medications, generic drugs will cost no more than $4.15 and name-brand medications will be no more than $10.35.
For level 4:
- The deductible is $0
- You’ll pay no more than $4.15 for generic medications, and no more than $10.35 for name-brand medications
- Once you and your plan have paid $7,400, you’ll pay $0 for each covered medication
What Happens After Signing Up?
You’ll automatically get Medicare Part D. You’ll get a letter that provides details about your new plan and what it covers, and what level of Extra Help you’ll get. From that point, you’ll receive Extra Help for the remainder of the year.
From then, you’ll only receive a letter if:
- You move out of your plan’s area
- You no longer qualify for Extra Help
- Your Extra Help plan changes
Call Us Today
At JA Agency, we’re here to make it easier for you to get the medical care you need. Whether it be low-cost drug plans or Medicare Advantage, we will give you the policy that gives you the greatest coverage for the lowest cost. Call us today at (551) 795-1229.