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Extra Help Medicare assistance program.

Receive assistance with paying for Medicare as well as other health care costs, including medications, from the Extra Help program. Qualified individuals can receive help for paying their annual deductibles, prescription drug co-payments, and monthly premiums, with a focus on Part D plans. The federal government Centers for Medicare and Medicaid Services as well as Social Security are coordinating this program for the needy.

Your State Health Insurance Counseling and Assistance Program (SHIP) also can help answer Medicare type payment and billing questions. Many people qualify for the savings from Extra Help but unfortunately don’t even know it. On average, the program will provide up to $4000 per year for your medical bills as well as other, health care costs. But as noted the financial aid is generally for Medicare prescription drug plan.

The cost savings are substantial. While the terms can change, in general the cost may be under $6 for generic drugs and even under $10 or $15 for approved, brand name medications. As noted, most of the federal government Extra Help is focused on Medicare Part D, but there may be some other benefits given as well.

Criteria for signing up for Extra Help

This program is for low income individuals and families, and is available in all 50 states as well as the District of Columbia. A number of conditions will need to be met by applicants. They include both income thresholds as well as total household assets/resources. Some current Medicare recipients will be contacted directly by a state or federal government agency such as the Social Security Administration because they automatically qualify.

Some low to moderate income senior or the disabled may already be eligible. People who already receive Medicaid, Supplemental Security Income (SSI) benefits, Programs of All-inclusive Care for the Elderly (PACE), or other Medicare Savings Programs will also usually qualify for Extra Help by default.

Note even ff you are not receiving benefits from one of those programs, you may still receive assistance. Additional details are below. Note that your total income, household assets, financial situation, and other resources will be considered. Also always feel free to contact your Social Security Administration (SSA) Office.




A married couple living together needs to have total resources less than about $30,000. This does not include assets such as your home, car, life insurance, or some other items. That limit is more for “liquid” assets, such as cash and stocks. So it is not as strict to get Extra Help.

Income scales are in place as well, and are partly based on the number of family members who live with you and whether you have a job. So if you have others that live with you, or income from a job, then the income scale will be higher for receiving Extra Help. If you have limited income and resources, then you also may be able to get assistance paying for other expenses such as deductibles and premiums.

The federal government estimates that about thirty five percent of seniors and others who receive Medicare can qualify for the Extra Help program, and many don’t know it. They can receive financial assistance with paying bills and expenses including prescription drug coverage.

Additional eligibility conditions are in place for individuals who are eligible for Medicare, and who are disabled and who have been receiving Social Security disability benefits for at least 24 months. Additional exceptions are made for patients who have amyotrophic lateral sclerosis (Lou Gehrig's disease) as well as those with kidney concerns.

Prescription drug coverage is offered for anyone who has Medicare. Assistance from Extra Help will not affect the receipt of your monthly disability payments, and your check from the federal government and/or social security will still be paid out at the same time. To learn more dial 1-800-772-1213 or try 800-633-4227.

Application Process

If you think you are qualified and you decide to apply for Extra Help, then you also can start the application process for a variety of other Medicare Savings Programs at the same time. Many states provide services or financial assistance that can help with paying other Medicare expenses.





As part of the application process, Social Security will send your information to your State. Note that you can prevent this from happening by indicating this on your Extra Help application. If your State is in fact sent the information, then they will contact you directly to help you apply for any other health insurance plans, Medicare Savings Programs, or discount services. Most of these state Medicare Savings Programs will assist low income people who also have limited resources and incomes. Your state may be able to help you pay for your health care costs, medical bills and other Medicare expenses.

Medicare Savings Programs can help qualified individuals pay for Part B and other health care insurance premiums. For some qualified people, the Medicare Savings Programs can also pay for Medicare Part A, which are hospital insurance premiums. Aid is also offered for Part A and B co-payments and deductibles.c As noted, to learn more or apply dial either 1-800-633-4227 or -800-772-1213.

Additional Medicare type assistance

Many people who enroll in Extra Help receive assistance from with paying a variety of other medical bills and expenses as well. The resources are as follows.

Medicaid is a program that is offered between federal and state governments as both contribute money towards running it. It can provide financial assistance to the low income, working poor, disabled, and others with limited incomes. It helps pay for healthcare costs and medical bills. You should call your State Medical Assistance office, or dial 1-800-633-4227.

Various coupons are available as well. they can be combined with Medicare Part D, Extra Help, and other assistance. Coupons are also very applicable to seniors as well. Find how to receive free coupons for prescription drugs.

Prescription drug cost assistance plans are offered in most states, and this will be in addition to the Extra Help program. People who qualify for the program, either through the application process or who may automatically qualify will receive free medication. Even if the drugs are not free, they may still receive  reduced out-of-pocket costs and other savings on drug coverage premiums. More details on free prescriptions.

PACE, or Programs of All-inclusive Care for the Elderly, is a combination of long-term care services, medical assistance, free or affordable home care and social services. It is offered in most states as part of Medicaid. Read more on PACE - Program of All-inclusive Care for the Elderly.

Supplemental Security Income benefits (medical assistance) is offered for the low income who are over 65 years of age, blind, and disabled. It is not the same what people think of and receive as general Social Security benefits. Dial 1-800-772-1213.


By Jon McNamara

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