Medicare is a federal health insurance program that provides coverage to individuals who are 65 years of age or older, as well as to those with certain disabilities. While Medicare covers many medical expenses, it doesn’t cover all your costs.

If you’re struggling to afford your healthcare, Medicare has a program called Extra Help that can be of great assistance to you. This program is designed to help you pay for your Medicare prescription drug costs.

However, Extra Help has specific income limits that determine eligibility. So, if you’re wondering whether you qualify for Medicare Extra Help, read on to learn about the 2023 income limits and other important information.

What are the income limits for 2023?

The income limits for Medicare Extra Help are established by the Social Security Administration and are updated annually. The limits are designed to provide financial assistance to you if you have limited income and resources and struggle to pay for your prescription drug costs.

In 2023, the income limit for individuals is set at $21,870, which represents a modest increase from the previous year. For married couples living together, the income limit is set at $29,580, which is also a slight increase from the previous year.

What is Medicare Extra Help?

Medicare Extra Help is a program that helps individuals with limited income and resources pay for their Medicare prescription drug costs. The program is also known as the Low-Income Subsidy (LIS). Extra Help can reduce the cost of prescription drug premiums, deductibles, and copayments.

The program is designed to help you save money on your prescription drug costs, making it easier for you to access the medications you need. On average, the program can save beneficiaries around $5,300 per year on their prescription drug costs. Some beneficiaries may save even more, depending on their individual circumstances. These savings can be significant if you have high prescription drug costs or limited income and resources.

Medicare Extra Help Eligibility

To be eligible for Extra Help, you must be enrolled in Medicare Part D. You must also meet the income and resource limits. As mentioned earlier, the income limit for individuals in 2023 is $21,870 and for married couples living together is $29,580. Resources include things like savings, investments, and real estate (other than your primary residence) are also considered when determining eligibility.

It’s important to note that if your income and resources are slightly above these limits, you may still qualify for some level of assistance. The amount of assistance you receive will vary depending on your specific circumstances.

Medicare Extra Help Benefits

If you’re eligible for Extra Help, you can receive a variety of benefits to help cover your prescription drug costs. These benefits include:

• Lower prescription drug premiums
• Lower prescription drug deductibles
• Lower prescription drug copayments
• No coverage gap (also known as the “donut hole”)

By reducing these costs, Extra Help can help make your medications more affordable, which can be especially important for anyone with chronic conditions who needs to take multiple medications.

Applying for Medicare Extra Help

If you think you might be eligible for Extra Help, you can apply online at the Social Security Administration’s website, or by calling the Social Security Administration at 800-772-1213. You’ll need to provide information about your income and resources, as well as other personal information, such as your Social Security number.

Conclusion

If you have limited income and resources and struggle to pay for your prescription drug costs, Medicare Extra Help can be a valuable program that provides you with financial assistance. This program can help you reduce the cost of prescription drug premiums, deductibles, and copayments, and eliminate the coverage gap. By making prescription drugs more affordable, Extra Help can be particularly important for you if you have chronic conditions that require multiple medications.

The income limits for Medicare Extra Help have been updated for 2023. For individuals, the income limit is now $21,870, and for married couples living together, it’s $29,580. These limits are based on income and resources, which may be subject to change in the future. If you think you may be eligible for Extra Help, it’s important to apply to see if you qualify. You can apply online at the Social Security Administration’s website or by calling the Social Security Administration.

Overall, the Extra Help program can provide you with significant financial relief if you need it, helping to ensure that you have access to the medications you need to maintain your health and well-being.

If you’re looking for assistance in finding a Medicare Part D Prescription Drug Plan, our team of licensed agents at Senior Healthcare Solutions is here to help! Our knowledgeable experts will provide you with personalized advice and guidance to help you find the right plan for your needs. Give us a call today at 866-MEDIGAP (866-633-4427) to speak with one of our experienced Medicare specialists.

Frequently Asked Questions

I have a Medicare Advantage Plan, do I qualify for extra help?

You may qualify for extra help if you have a Medicare Advantage that includes drug coverage. If that’s you, the next step is to apply online. LIS Eligibility is based on income.

I have a Medicare Supplement Plan, do I qualify for extra help?

Just because you have a Medicare Supplement plan doesn’t mean you qualify for extra help.

Extra help is designed to help with your prescription cost. And because Medicare Supplement plans don’t include drug coverage, you wouldn’t be eligible.

However, if you have a stand-alone drug plan along with your supplement, than you may be eligible for extra help (LIS(). Its easy to apply, click here https://secure.ssa.gov/i1020/start

What benefits does Medicare Extra Help provide?

Medicare Extra Help provides benefits such as lower prescription drug premiums, deductibles, and copayments, as well as no coverage gap.

How much does each generic prescription cost?

The cost of each generic prescription for beneficiaries who qualify for Extra Help under Medicare Part D will depend on the specific plan that they are enrolled in. The costs of generic prescription drugs can vary significantly depending on the plan’s formulary, which is the list of prescription drugs that the plan covers, and the pricing agreements that the plan has with different pharmacies.

Do you have to reapply for Extra Help every year?

No, you don’t have to reapply for Extra Help every year. Once you are approved for Extra Help, your eligibility is typically reviewed annually to determine if you still qualify. The Social Security Administration will send you a notice to let you know if your eligibility is changing or if you need to provide updated information. If your income or resources change, you should report those changes to the Social Security Administration so that your Extra Help benefits can be adjusted accordingly.

Can I still qualify for Medicare Extra Help if my income and resources are above the limits?

Yes, you may still qualify for Medicare Extra Help even if your income and resources are slightly above the limits. The amount of Extra Help you receive is determined by your level of need, which is based on your income and resources.

Is Medicare Extra Help the same as Low-income Subsidy (LIS)?

Yes, Medicare Extra Help and Low-Income Subsidy (LIS) are the same thing. “Extra Help” is the name given to the low-income subsidy program that assists individuals with limited income and resources in paying for their Medicare Part D prescription drug costs.