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 SS check by $99.90 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 Missouri City
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.
This 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 2012 income must be limited to $16,335($1,361.25) for an individual or $22,065($1,838.75) 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 $12,640 for an individual or $25,260 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 have your Part B $99.90 premium paid for, your Part D premium also can be paid for and 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.
You may qualify for one of the options or all 3 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!!
I would suggest that you go to http://www.socialsecurity.gov/prescriptionhelp/ or call 1/800-772/1213 and ask about Extra Help application, # (SSA-1020) Visit pages 98-102 of your 2012 Medicare & You handbook for more information of “Extra Help” and “Help with Medicare Costs”.
I have recently released my new 2013 edition of Medicare Survival Guide where Medicare and other senior issues are explained in simple terms. The book is available at www.tonisays.com and is not in bookstores.
Or just call me and we can talk about your prescription drug problems or any other Medicare issues since Open Enrollment is ending on Friday December 7th 2012.
Hello Toni:
How can I get a copy of the Medicare and You handbook that you are always referring to? I am turning 65 in March and would like to have one to study. Sam… an Examiner Reader.
Sam:
Unless you are already 65, Medicare will not send you a handbook. But you can go to a local Social Security office and get a 2012 or maybe a 2013 Medicare and You handbook. For the fastest way… go to www.medicare.gov and download a copy of the most current Medicare & You handbook.
Toni King author of the Medicare Survival Guide which is now available 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).
