MEDICARE MEMBERS: PROTECT YOURSELF AGAINST MEDICARE FRAUD AND IDENTIFY THEFT! THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE OF INSPECTOR GENERAL IS ALERTING THE PUBLIC ABOUT A FRAUD SCHEME INVOLVING GENETIC TESTING. LEARN HOW TO PROTECT YOURSELF.
Medicare Extra Help | Allwell from PA Health and Wellness
Medicare's "Extra Help" Program
The Medicare Extra Help program is for anyone that has Medicare and Medicare Prescription Drug (Part D) coverage, but have limited income and resources such as savings and stocks. This does not include your home or car.
What does Medicare Extra Help cover?
The Extra Help program can save you up to $5,000 each year. Many people qualify for this savings but don’t know it.
If you qualify for the Extra Help program, you will get help paying for Medicare prescription drug costs that is a part of your Part D coverage such as your monthly premium, yearly deductible, prescription co-payments and coinsurance. This Extra Help also counts toward your out-of-pocket costs.
See if You Qualify for Extra Help
Some people automatically qualify for the Extra Help program and don't need to apply. Medicare will mail you a letter if you automatically qualify for Extra Help.
Your income and resources can change from year to year, so check to see if you qualify for the program if you didn’t receive a letter from Medicare or were previously denied for the Extra Help program.
Apply for Extra Help
Applying for Extra Help is easy. Just complete the Social Security’s application for the Medicare Extra Help program in the following ways.
After you apply, you will get a letter letting you know if you qualify for Extra Help and what you need to do next.
Level of Extra Help (Low Income Subsidy)
Your total monthly plan premium, copays, and deductibles may vary based on the level of Extra Help you receive.
The Low Income Subsidy (LIS) table shows you what your monthly plan premium will be if you get Extra Help.
Please select the document for your plan and county. If you have questions, call Member Services. We’re here to help.
Medicare’s Extra Help Program
Get Extra Help Paying Your Medicare Drug Costs
Extra Help is a Medicare program to help people with limited income and resources pay for their Medicare prescription drug coverage, such as plan premiums, deductibles, copays or coinsurance. Additionally, those who qualify will not have a coverage gap or late enrollment penalty.
Qualifying for Extra Help
To qualify for Extra Help, you must have Medicare and have limited income and resources. You must also reside in one of the fifty states or the District of Columbia. You may automatically qualify for Extra Help If you have Medicare and meet any of these conditions:
- You have full Medicaid coverage
- You get help from your state Medicaid program paying your Part B premiums (in a Medicare Savings Program)
- You get Supplemental Security Income (SSI) benefits
If you have automatically qualified for Extra Help, you’ll receive a purple letter in the mail from Medicare. It’s important to keep this letter for your records.
Applying for Extra Help
If you didn’t automatically qualify for Extra Help, you can apply at any time. You’ll need to complete Social Security’s application for the Medicare Extra Help program in one of the following ways.
- By Phone: call Social Security at 1-800-772-1213 (TTY users call 1-800-325-0778)
- Online: Complete an application using Social Security’s Online Application Form
Note that if you qualify for Extra Help and don’t already have Medicare drug coverage (Part D), you must join either a Medicare Advantage plan with Prescription Drug Coverage or a separate Medicare Prescription Drug Plan to use Extra Help.
Level of Extra Help
If you receive Extra Help from Medicare, your monthly plan premium will be lower than what it would be if you did not receive Extra Help. The amount of extra help you receive will determine your total monthly plan premium. The Premium Subsidy Chart shows you what your monthly plan premium will be if you receive extra help.
Please select the document for your plan and county.
- Low Income Subsidy (LIS) - English (PDF) - coming soon