You Could Get Extra Help Paying for Medicare Part D Drug Costs | Empire Skip To Main Content
Health Insurance Basics

You Could Get Extra Help Paying for Medicare Part D Drug Costs

August 25, 2017

Do you have Medicare and find it hard to pay for the medications you need? You or someone you care for may be among the many Medicare Part D participants on fixed incomes who face difficult decisions about money and spending. That’s why it’s important to know: Extra Help is available to those who qualify.

Extra Help Is a Federal Program That Helps Participants Pay for Medicare Drug Costs

Many people over 65 are surprised to hear they may be eligible for a low-income subsidy program that provides financial assistance. Also known as the Extra Help Medicare Part D program. It can help pay prescription drug monthly payments, deductibles and copayments.

The Social Security Administration and Medicare work together to offer the Extra Help program and provide Medicare Part D assistance by controlling drug program out-of-pocket expenses. And the savings can really make a difference. According to Social Security, participants who qualify for the federal Extra Help program could save up to $4,000 a year in prescription drug costs.

Here’s How You Can Save on Medicare Part D With Extra Help

The Extra Help program makes it possible for participants to pay:

  • $0 or a very low amount on monthly premiums for Medicare Part D.
  • $0 or a very low amount on a yearly deductible for prescription medications.
  • No more than $3.30 generic/$8.25 brand-name copayments or 5% coinsurance for each covered prescription in 2017.

Also, participants who are eligible for Extra Help can enroll in Medicare Part D at any time without facing late enrollment penalties.

It’s Easy to Find Out If You’re Eligible for Extra Help

To qualify for Extra Help, a person must be receiving Medicare and currently have or sign up for a Part D plan, have limited resources and income, and reside in one of the 50 states or the District of Columbia.

Most qualified participants’ annual income and financial resources (including savings accounts, IRA accounts, stocks, and bonds) are limited to levels specified by Social Security. For 2017, these limits are:

  • $18,090 in yearly income and up to $13,820 in assets for an individual.
  • $24,360 in yearly income and up to $27,600 in assets for a married person living with a spouse.

There are some exceptions, however, and some people with higher incomes still might qualify — so it’s smart to check with Social Security.

Remember, even if you don’t qualify for Extra Help, you can still enroll in an approved Medicare prescription drug plan for coverage to help you manage Medicare costs.

Y0114_17_32256_I 08/14/2017
68128MUSENMUB

A CONSUMER’S GUIDE TO HEALTH INSURANCE FOR PEOPLE ELIGIBLE FOR MEDICARE MAY BE OBTAINED FROM YOUR LOCAL SOCIAL SECURITY OFFICE OR FROM THIS INSURER

Empire BlueCross BlueShield is an HMO plan with a Medicare contract. Enrollment in Empire BlueCross BlueShield depends on contract renewal. Services provided by Empire HealthChoice HMO, Inc. licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans.

Services provided by Empire HealthChoice Assurance, Inc., licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. Call our Customer Service number, (TTY: 711). ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame a nuestro número de Servicio de Atención al Cliente (TTY: 711). 注意:如果您使用非英語的其他語言,您可以免費獲得語言援助服務。請致電聯絡客戶服務部(聽語障用戶請致電:711)。