Can I get help with my Medicare prescription drug costs?
Medicare offers a program called Extra Help to people with low incomes and limited assets. This is sometimes called Low Income Subsidy or LIS.
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How to apply for Extra Help
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Step 1: Choose a drug plan provider
Whether you qualify for Extra Help or not, you must enroll for prescription drug coverage in order to apply for Extra Help.
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Step 2: Complete an application for Extra Help
Complete the online application. The Social Security Administration will review your application and send you a letter to let you know if you qualify for Extra Help with Part D costs.Â
You may automatically receive Extra Help
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If you meet any one of the criteria below, you will automatically receive Extra Help from Medicare to help with your Part D costs. There's no need to apply.
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- You receive both Medicare and Medicaid
- You receive both Supplemental Security Income (SSI) benefits and have Medicare
- The state pays your Medicare premiums
If you aren't getting Extra Help, you can see if you qualify by calling:
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- 1-800-Medicare (TTY/TDD users call 1-877-486-2048), 24 hours a day/7 days a week
- Your State Medicaid Office or
- The Social Security Administration toll-free at 1-800-772-1213. TTY/TDD users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday
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If you have any questions, please contact UnitedHealthcare Customer Service.
Best Available Evidence Policy
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The federal Best Available Evidence (BAE) policy requires that the plan adjust your subsidy if you provide updated information that changes the level of Extra Help you receive. A memo on the CMS website explains the procedures for updating a person's level of Extra Help.
Counting your assets
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To determine your eligibility, Medicare may also look at your assets. Assets Medicare counts include:
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- Cash (including checking and savings accounts)
- Certificates of deposit
- Retirement accounts (like IRAs or 401(k)s)
- Stocks, bonds and mutual funds
- Promissory notes
- Property that could be converted to cash within 20 days
- Mortgages
- Life insurance policies
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Medicare does not count these assets:
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- Your primary home
- Your primary car
- Burial plots or agreements
- Funds set aside for burial expenses (up to $1,500 per person)
Premiums for members receiving Extra Help
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To learn more about plan premiums for people receiving Extra Help, please contact UnitedHealthcare Customer Service.
State Pharmaceutical Assistance Programs
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A State Pharmaceutical Assistance Program (SPAP) provides state-funded prescription drug assistance to people who need help paying for their monthly prescription drug plan premiums, deductibles, copays and coinsurance.
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For most programs, members must meet specific income guidelines and additional requirements that vary by state.
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To find out how to contact your state SPAP, visit www.medicare.gov/pharmaceutical-assistance-program/state-programs.aspx.