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Getting Extra Help With Medicare Prescription Drug Plan Costs

Information For Medicare Beneficiaries With Disabilities

SSA Publication No. 05-10118, January 2010, ICN 444800 (En Español) (View bilingual .pdf) Get Accessible Adobe Acrobat Reader [Audio.mp3] audio icon
 


If you are disabled and have been receiving Social Security disability benefits for 24 months, you are eligible for Medicare. Disability beneficiaries who have amyotrophic lateral sclerosis (Lou Gehrig's disease) are eligible for Medicare without waiting 24 months. Similarly, disabled beneficiaries and specially insured individuals who have permanent kidney failure that requires maintenance dialysis or a kidney replacement are eligible for Medicare. Any-one who has Medicare can get Medicare prescription drug coverage. If you have limited resources and income, you also may be able to get Extra Help paying for the monthly premiums, annual deductibles and prescription co-payments related to a Medicare prescription drug plan. The Extra Help will not affect the receipt of your monthly disability payments.

To qualify for Extra Help:

  • You must reside in one of the 50 states or the District of Columbia


  • Your resources must be limited to $12,510 for an individual ($25,010 for a married couple living together). Resources include such things as bank accounts, stocks and bonds. We do not count your home and car as resources; and


  • Your annual income must be limited to $16,245 for an individual ($21,855 for a married couple living together).

Even if your annual income is higher, you still may be able to get some help with your monthly premiums, annual deductibles and prescription co-payments. Some examples where your income may be higher include if you or your spouse:

—Support other family members who live with you;

—Have earnings from work; or

—Live in Alaska or Hawaii.

Note: Beginning January 1, 2010, more Medicare beneficiaries may qualify for Extra Help because some things no longer count as resources and income. We will no longer count as a resource any life insurance policy; and we will no longer count as income the help you receive regularly from someone else to pay your household expenses—food, mortgage, rent, heating fuel or gas, electricity, water, and property taxes.

If you are not getting the Extra Help automatically, it is easy to apply. Just complete Social Security's Application for Extra Help with Medicare Prescription Drug Plan Costs (Form SSA-1020). Here’s how:

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How can state agencies help you with Medicare costs?

Beginning January 1, 2010, when you file your application for Extra Help, you also can start your application process for the Medicare Savings Programs—state programs that provide help with other Medicare costs. Social Security will send information to your state unless you tell us not to on the Extra Help application. Your state will contact you to help you apply for a Medicare Savings Program. These Medicare Savings Programs help people with limited resources and income pay for their Medicare expenses. The Medicare Savings Programs help pay for your Medicare Part B (medical insurance) premiums. For some people, the Medicare Savings Programs also may pay for Medicare Part A (hospital insurance) premiums, if any, and Part A and B deductibles and co-payments.

If you think you might be able to get help from your state with Medicare costs, or if you are not sure, call your state medical assistance (Medicaid) office or call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048).

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How can you get more information?

For more information about getting Extra Help with your Medicare prescription drug plan costs, visit www.socialsecurity.gov/extrahelp or call Social Security at 1-800-772-1213 (TTY 1-800-325-0778). Social Security representatives are available to help you complete your application.

If you need information about Medicare Savings Programs, Medicare prescription drug plans, how to enroll in a plan, or to request a copy of the Medicare & You handbook, please visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048). When you call, you can request information about how to contact your State Health Insurance Assistance Program (SHIP). Your SHIP can help you with your Medicare prescription drug plans. You also can find your local SHIP contact information in the back of your Medicare handbook or obtain the information online at www.medicare.gov/contacts/staticpages/ships.aspx.

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