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What exactly does Medicare Extra Help cover and how do I get it?

medicare-extra-help-guide

A number of programs are available to assist with healthcare costs, including Medicare Extra Help. Read on to learn how Extra Help can reduce your costs and find out if you might be eligible.

What Medicare Extra Help Covers

Extra Help provides various levels of assistance with the cost of prescription drug coverage under Medicare. The program sets standard costs for all generic and name-brand prescription drugs. Depending on income level, the program may also cover the premiums and deductibles for Medicare Prescription Drug Plans.

How to Get Medicare Extra Help

Some circumstances make you automatically eligible for Extra Help, including:

  • Having full Medicaid coverage
  • Being enrolled in a Medicare Savings Program
  • Receiving Supplemental Security Income (SSI)

Individuals who’re automatically eligible don’t need to apply for Extra Help. Even if you’re not automatically eligible for Extra Help, you may still qualify. You can find out by submitting an application.

Applications for Extra Help are available through the Social Security Administration (SSA). You can apply for Extra Help online or call the SSA at 1-800-772-1213 and request a paper application.

You’ll need several documents for your application, including your Social Security Card, bank statements, and tax returns.

Using Medicare Extra Help

To make use of Extra Help, you must be enrolled in a Medicare Prescription Drug Plan (Part D) or Medicare Advantage Plan with prescription drug coverage (MA-PD). Enrollment in a plan is separate from the Extra Help application and plans are specific to your geographic area. If you have Extra Help, you can enroll in, drop, or change Medicare Prescription Drug Plans at any time.

For help finding a Medicare Plan that’s right for you, call our Medicare Advocates at 1-800-991-4407 / TTY 711, 10 a.m. to 9 p.m. Eastern Time, Monday through Friday. You can also find, compare, and enroll in Medicare Advantage Plans through the Medicare Online Enrollment Portal.

Other Financial Assistance Options

Extra Help isn’t the only way to receive assistance with healthcare costs under Medicare. In addition to Medicare coverage, you may be eligible for Medicaid assistance based on income, known as dual eligibility. Combined, the two programs cover most medical costs through Medicare Savings Programs. If you’re uncertain about your Medicaid eligibility, research Medicaid in your state. Medicaid programs, including eligibility and applications, are entirely state-specific. Learn more about dual eligibility.