Extra Help, also known as Part D Low Income Subsidy (LIS) is a federal program that comes from the Social Security Administration to assist those with limited means of income in paying for their prescription drugs. The assistance pays either some or most of a portion of the out-of-pocket costs of Medicare prescription drug coverage. It will also pay for Part D’s premium up to a state-specified benchmark amount. Depending on the beneficiary’s monthly income and asset amount, one may either qualify for for partial or full Extra Help. The beneficiary must keep in mind that in order to receive Extra Help, they must be enrolled in a Medicare Part D Plan.
In order to be eligible for Extra Help, the beneficiary’s monthly income must fall within certain parameters. There is a chart available on medicareinteractive.org that show specified monetary limits. However, in 2019, the limit is up $1,581 monthly income for singles and $2,134 for couples. These limits do include a $20 disregard from the Social Security Administration that is automatically subtracted from monthly retirement income. Even if total monthly income and assets add up to more than the specified limits, you could still qualify if certain forms of income or assets are not counted. Being enrolled in Medicaid, SSI (supplemental security income) or a Medicare Savings Program will also automatically qualify you for Extra Help, regardless of Extra Help’s income parameters. The Centers for Medicare and Medicaid Services will send a notice informing you that you do not need to apply for Extra Help.
To apply for the Extra Help program, you can go through the Social Security Administration and either send in a printed application or apply online at www.ssa.gov.
Remember, you can only receive Extra Help if you are enrolled in Part D. If you qualify for Extra Help, but are not on a Part D plan, this will give you a special enrollment period to enroll in a Medicare Part D plan and receive Extra Help on your prescription drugs.
If your Extra Help application is denied, or receive less than you think you qualify for, you can appeal to the SSA.
If you have questions or are confused about what you will be liable for, book a meeting with an agent. The goal is to lower your potential cost as low as possible while still receiving great medical care when you need it and give you peace of mind.