Medicare recipients with limited income might be able to quality for extra help with any costs associated with prescription drugs. This program is called a “Low Income Subsidy” (LIS) or “Extra Help,” and it offers supplemental coverage to Medicare Part D. The Social Security Administration (SSA) as well as the Centers for Medicare and Medicaid Services (CMS) work together to offer this extra benefit, and some people will get it automatically. This includes anyone who is eligible for both Medicare and Medicaid, anyone who is getting Supplemental Security Income (SSI), and anyone who is able to get a Medicare Savings Program. They don’t have to apply for this program, but they should still speak to a benefits counselor so they can find the best Part D plan for their specific situation. Everyone else will have to apply through Social Security to get extra help.
The Benefits of Getting Extra Help on Medicare Coverage
The amount of extra help you can get will depend on your income. You may get a full subsidy, or you may only get a partial subsidy. Most people who are eligible for extra help will pay:
- No premiums on Medicare Part D
- No deductibles (unless you receive a partial subsidy)
- Lower costs for every drug that’s covered by Medicare (https://www.cms.gov/Medicare/Eligibility-and-Enrollment/LowIncSubMedicarePresCov/index)
Aside from lower out-of-pocket costs, a Low-Income Subsidy can give you the following protections:
- Quarterly Special Enrollment Periods — Once every three months from January to September and once during the annual open enrollment period. This allows people with extra help to sign up without having to wait for the annual open enrollment period (October 15 – December 7). Any changes that you made outside of annual open enrollment will go into effect the following month, which is helpful for seniors and adults with disabilities who may need to take medications that aren’t covered on their current plan.
- No Part D Late Enrollment Penalty — You won’t pay a penalty, even if you sign up late (that is, if you were initially eligible for Medicare Part D and you didn’t have any other prescription drug coverage).
Be sure to speak to someone at JWB Insurance for more information, so you can find out if you qualify for extra help.
How to Apply for Extra Help
We’re an insurance agency in Houston with the knowledge and experience to help you with life, health, and Medicare coverage. We can even give you access to a number of Medicare plans that can take care of any coverage gaps from standard Medicare. If you think you might be eligible for extra help, JWB Insurance can help you apply.