Advertiser Disclosure

Extra Help – Financial Assistance for Medicare Prescription Drug Costs

2 mins read
Our goal is to give you the tools and confidence you need to improve your health and finances. Although we may receive compensation from our partner insurance companies, whom we will always identify, all opinions are our own. CoverRight Inc. and CoverRight Insurance Services Inc. (NPN: 19724057) are collectively referred to here as "CoverRight".

Extra Help, also known as the Low-Income Subsidy (LIS) program, is a valuable financial assistance program provided by the government to help Medicare beneficiaries with limited incomes and resources pay for their prescription drug costs. This program offers significant support in covering out-of-pocket expenses related to prescription medications, making essential medications more affordable and accessible for eligible individuals. Understanding Extra Help is crucial for Medicare beneficiaries who may face challenges affording their medications, as it can significantly reduce the financial burden and improve access to necessary healthcare. In this article, we delve into the concept of Extra Help, its eligibility criteria, and the benefits it provides to eligible Medicare beneficiaries.

What is Extra Help?

Extra Help is a program administered by the Social Security Administration (SSA) that provides financial assistance to qualified Medicare beneficiaries for their prescription drug costs. It is designed to support individuals with limited income and resources in affording their medications, ensuring they can access necessary treatments and maintain their health.

Eligibility for Extra Help

To be eligible for Extra Help, Medicare beneficiaries must meet certain income and resource criteria, which are adjusted annually. The eligibility is based on both individual and household income and resource levels. As of 2021, the following income and resource limits apply for Extra Help:

  • Income Limit: The annual income must be below a specific threshold, which may vary each year. For 2021, the individual’s annual income should be below $19,320, and for couples, it should be below $26,130.
  • Resource Limit: The total value of the individual’s assets, including bank accounts, investments, and property (excluding the primary residence and some other exclusions), should not exceed $14,790 for individuals and $29,520 for couples in 2021.

Benefits of Extra Help Qualified Medicare beneficiaries who receive Extra Help may enjoy the following benefits:

  1. Reduced Prescription Drug Costs: Extra Help significantly lowers out-of-pocket costs for prescription medications, including premiums, deductibles, and copayments.
  2. No Late Enrollment Penalty: Beneficiaries receiving Extra Help are exempt from late enrollment penalties for Medicare Part D prescription drug coverage.
  3. Continuous Coverage: Extra Help ensures continuous access to prescription drug coverage, even if the beneficiary experiences changes in their financial situation.

How to Apply for Extra Help

To apply for Extra Help, eligible individuals can take the following steps:

  1. Contact Social Security Administration: Call the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778) or visit their website to apply online.
  2. Provide Necessary Information: The applicant will need to provide information about their income, resources, and other relevant details.
  3. Receive Confirmation: Once the application is reviewed and approved, the applicant will receive a confirmation notice indicating their eligibility for Extra Help.

Extra Help, also known as the Low-Income Subsidy (LIS) program, is a valuable financial assistance program that supports eligible Medicare beneficiaries in affording their prescription drug costs. By reducing out-of-pocket expenses, Extra Help ensures that individuals with limited incomes can access necessary medications and maintain their health more effectively. Beneficiaries should check their eligibility and apply for Extra Help if qualified, as it can significantly alleviate the financial burden of prescription drug expenses and provide essential support for better healthcare outcomes.

Tara Lemcke

Tara is an Content Writer at CoverRight focused on supporting the production of written and video content including researching, editing and publishing Medicare and health insurance-related information.

Latest from Blog