Toni,
Please give me some advice because I am having some financial problems. I am concerned that I will get into the Donut Hole. I only receive about $1,050.00 income from my social security check. The Medicare Part B premium has reduced my Social Security check by $104.90 for medicare coverage.
I have heard that there is a way I can receive an “Extra Help” for assistance with my Medicare prescription drug’s out of pocket. Can you give me information on this subject? Thanks so much, Bonnie in Sugar Land.
Bonnie:
You are correct that there is a special program from Social Security to help people receive “Extra Help” with Medicare Prescription Drug (Part D) plan cost. Go to this link http://www.socialsecurity.gov/prescriptionhelp/, click on “Chubby Checkers” and learn about Extra Help. The Houston-Galveston Area Agency on Aging at 1/800-437-7396 announced this week that they can help with applications for these programs over the phone and answer questions.
Curtis Cooper, Manager of the Houston-Galveston Area Agency on Aging said. “Medicare’s assistance programs can result in big savings for those who qualify. The Extra Help program, which has the highest income limits, saves a person on Medicare an average $4,000 a year on prescription premiums, deductibles and co-pays.”
“Extra Help” is also known as Low Income Subsidy or LIS and is provided by Social Security, but it is not part of the State Medicaid program because the income levels are a bit higher than trying to qualify for Medicaid.
To qualify, your 2013 income must be limited to $17,232($1,436) for an individual or $23,268($1,939) for a married couple living together. This year they have raised the amount for resources which can be real estate, bank accounts, stocks, CDs, mutual funds, IRAs and cash at home but they no longer count your house, car and life insurance as a resource. The value of what you own must be limited to $13,300 for an individual or $26,580 for a married couple. What is so great about LIS (extra help) is that when you are approved; then, there can be different levels that you can qualify for, depending on how much your annual income and resources are. You may qualify to have your Part B $104.90 premiums paid for. That income level is below $1,313 for an individual and $1,765 for couples. Also you may qualify to have covered your Part A and Medicare Part B premiums, deductibles and co-pays expenses if your monthly income is below $975 for an individual or $1,313 for a couple.
If you qualify your prescriptions co pays will be reduced to $2.60 for generics or $6.50 for brand name drugs. One thing that is really great about LIS (extra help) is that the “Donut Hole” can be eliminated if you qualify so a $200 or $2,000 or whatever the cost of a brand name prescription will only be $6.50.
When I refer to “qualify” for a program remember that Social Security and the state are looking over your income and assets. You may qualify for one of the options or all 4 options, depending on how much your income is. Each year, you must re-qualify for that year’s Extra Help program and if you get a cost of living increase or anything that can change your annual income amount, then you may not qualify, due to making too much!!
Visit pages 98-102 of your 2012 Medicare & You handbook for more information of “Extra Help” and “Help with Medicare Costs”.
Toni King, author of the Medicare Survival Guide which is on sale at www.tonisays.com. Toni is an advocate/consultant for those “Confused about Medicare”. Email questions to toni@tonisays.com or call 832/519-TONI (8664). Beginning Saturday March 9th listen to Toni at 11:00 AM each Saturday for the Medicare Survival Guide Hour on 100.7 FM KKHT “The Word” and 1070 AM “The Answer”. It will be a call in show… so have plenty of questions for Toni.
