Staying Fit
Yes. The Extra Help program can help people with limited resources and income pay premiums and out-of-pocket costs for Medicare Part D prescription coverage.
Medicare doesn’t automatically cover prescription drugs though you can get a Part D policy from a private insurer that helps with these expenses. But stand-alone Part D policies still have some costs, including premiums that average $31.50 a month in 2023, deductibles at $505 or less annually in 2023 and copayments or coinsurance for your medications.
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If you qualify, the Extra Help program, also called the Part D low-income subsidy, can reduce these out-of-pocket expenses. Depending on your income, it may eliminate them.
The Social Security Administration, which runs the Extra Help program with the Centers for Medicare & Medicaid Services, estimates that the program can reduce prescription drug expenses for low-income beneficiaries by an estimated $5,300 a year.
Who qualifies for Extra Help with Part D premiums?
Some qualify automatically. If you receive full Medicaid coverage, get Supplemental Security Income (SSI) or have your Medicare premiums paid through a state program, Medicare will send you a letter confirming that you’re eligible for Extra Help and don’t need to apply.
Others can apply. If your assets and income are low enough, you can qualify for full or partial Extra Help. The limits change each year.
- Your assets — savings, investments and real estate, not counting the home you live in — must be worth $33,240 or less in 2023 if you’re married and living with your spouse. If you’re not married or not living with your spouse, the amount is $16,660 or less.
You don’t need to include these items in your calculations: your home, burial plots, irrevocable burial contracts, life insurance, personal possessions, vehicles or certain back payments from Social Security or SSI.
- Your income must be less than $29,820 for a married couple living together and $22,116 for an individual. Income includes money you receive from Railroad Retirement, Social Security and Veterans Affairs benefits; net earnings from self-employment; other pensions; rental income; wages; and some other kinds of income.
You can apply for Extra Help through the Social Security Administration, which also handles Medicare enrollment. There are three options: fill in the forms on the SSA website, call Social Security (800-772-1213) or schedule an appointment at your local Social Security office.
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Monthly premiums, other out-of-pocket expenses can add up