Many Americans struggle with the high cost of health care, but there is hope. Low-income subsidies can provide relief to eligible individuals. For Medicare beneficiaries, financial assistance options include Extra Help, Medicare Savings Programs and Medicaid.
Unfortunately, some people may struggle on their own simply because they are unaware of these programs or don’t realize that they qualify. Your clients may be among this group. You can prove your value as a caring agent by helping them find out if they qualify for low-income subsidies.
Applying for Extra Help
Extra Help is the name of the Medicare program that helps people with limited income and resources pay for prescription costs, including premiums, deductibles and coinsurance. People in the program pay no more than $3.35 for generic prescriptions and $8.35 for covered brand-name prescriptions in 2018.
Some people may receive a notice informing them that they automatically qualify for Extra Help. Otherwise, people can apply for the program. To qualify, a person needs to be enrolled in Medicare Parts A and B and no more than $14,100 in savings, investments and real estate for individuals or $28,150 for couples.
Learn more about how to qualify and start an application at the Social Security Administration’s site. If you think your clients might benefit from this program, tell them about it and encourage them to apply.
Applying for Medicare Savings Programs and Medicaid
Medicare Savings Programs help people pay for Medicare Parts A and B. There are four types of programs.
- The Qualified Medicare Beneficiary Program helps with premiums, deductibles, coinsurance and copayments for Parts A and B.
- The Specified Low-Income Medicare Beneficiary Program helps with Part B premiums.
- The Qualifying Individual Program helps with Part B premiums.
- The Qualified Disabled and Working Individuals Program helps with Part A premiums.
See the Medicare.gov website for more information, including the income and resource limits.
These programs are run through the state. If your clients are interested in applying, they need to contact their state’s Medicaid program.
Medicaid can also provide help for services that Medicare does not cover, including personal care services.
To find the right contact information for your state, use this Medicare.gov form.
Individuals whose income and resources are slightly higher than the limits are encouraged to apply anyway, as the limits may be raised for 2019. Also, the limits are slightly higher in Hawaii and Alaska. When in doubt, encourage your clients to apply!
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