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the medicare drug plan
6 Key Facts

1. Anyone on Medicare can get coverage regardless of income or health.

2. You are not obligated to enroll, but there may be consequences if you don't sign up when you are first eligible to do so.

3. To get Medicare drug coverage, you must select one approved private drug plan among many offering different choices. There is no single government plan.

4. Is your income limited? If you qualify for a part of the program known as "Extra Help." you'll pay very little for your medications.

5. Are your drug costs very high? You'll pay no more than 5 percent of the cost of each prescription after you've spent a certain amount of money out-of-pocket in any one year.

6. Do you have better drug coverage already? You probably won't need Medicare's Part D coverage. But it's wise to check.

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Medicare Prescription Drug Coverage Guide

Part 2: 'Extra Help' Paying for Prescriptions

On limited income, you may qualify for more assistance

What counts as income?

It includes money you receive from Social Security, wages, dividends, alimony and rental property. It does not include funds acquired through loans or a reverse mortgage.

What counts as assets?

Assets include bank accounts, IRAs and the value of investments, and extra real estate. They do not include your home, vehicles, personal possessions, burial plots or up to $1,500 in savings intended for funeral expenses.

What if I’m married but we live apart?

You count as single for the income and asset tests. You also count as single if your spouse’s stay in a nursing home is likely to be permanent. Check with the Social Security Administration if you’re not sure.

What if my income is a little too high?

It’s still worth applying. The income limit is higher if you live in Alaska or Hawaii, have dependent relatives living with you or have certain earnings that don’t count. Also, remember that the limits go up slightly every year. The Social Security Administration announces the new limits each February or March.

What if my assets are a little too high?


Social Security Administration rules do not prevent you from spending down or giving away some of your savings to reduce assets below the limit. Only what you have at the time you apply counts as assets. But be aware that spending down might affect your eligibility for other programs (such as Medicaid and SSI) should you need them within a few years.

How do I know if I qualify?

If you receive Medicaid or SSI or your state pays your Medicare premiums, you qualify automatically, and Medicare should notify you of this. Otherwise, you can apply to the Social Security Administration at 1-800-772-1213 or online at the Social Security website or in person at your local SSA office. If you’re new to Medicare, you will probably receive an Extra Help application form in the mail. After receiving your application, SSA will notify you whether or not you qualify. You have the right to appeal that decision.

Can my spouse and I apply for Extra Help together?

Yes. You can use the same application form if both of you apply at the same time. Even if only one of you is applying, you must still give details of your spouse’s income and assets and your spouse must also sign the form.

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