Dear Savvy Senior: Are there any special Medicare programs that help seniors with their medication costs? My 74-year-old mother, who lives primarily on her Social Security, takes several high-priced drugs that sap her income even with her Medicare drug plan. — Looking for assistance
Dear Looking: Yes, there’s a low-income subsidy program called Extra Help that can assist seniors on a tight budget by paying for their premiums, deductible and co-payments in their Medicare (Part D) prescription drug plan.
Around 10 million people are receiving this subsidy, but another two million may qualify for it and don’t even realize it. They’re missing out on hundreds or thousands of dollars in savings each year.
Changes in the law make it easier to qualify for the program. Even if your mom applied and didn’t qualify before, she may be eligible now. The amount of additional assistance depends on income and assets. If your mom qualifies for help, she’ll pay no more than $3.35 for a generic drug and $8.35 for a brand-name drug.
To get the subsidy, your mom’s assets can’t be more than $14,100 (or $28,150 for married couples living together). Bank accounts, stocks and bonds count as assets, but her home, vehicle, personal belongings, life insurance and burial plots do not.
How to apply
There are three ways to apply for Extra Help: online at SSA.gov/prescriptionhelp; by calling Social Security at 800-772-1213; or by visiting a local Social Security office.
The application form is easy to complete, but you’ll need your mom’s Social Security number and information about her bank balances, pensions and investments. Social Security will review her application and send her a letter within a few weeks letting you know whether she qualifies.
If your mom doesn’t qualify for Extra Help, she may still be able to get help from a state pharmacy assistance program or a patient assistance program. Visit BenefitsCheckUp.org and click on “Medications” to search for these programs.
Other Medicare assistance
If your mom is eligible for Extra Help, she may also qualify for help with her other Medicare expenses through her state’s Medicare Savings Program.
State Medicaid programs partner with the federal government, so income and asset qualifications vary depending on where she lives. Medicare Savings Programs will pay her entire Medicare Part B premium each month. Some also pay for Part B coinsurance and copayments, depending on her income. Contact your mom’s state Medicaid office to determine if she qualifies for benefits.
You can also get help through her State Health Insurance Assistance Program (SHIP), which provides free one-on-one Medicare counseling in person or over the phone. To locate a SHIP counselor, visit ShiptaCenter.org or call the eldercare locator at 800-677-1116.
Jim Miller is a contributor to NBC-TV’s “Today” program and author of “The Savvy Senior.” Send your questions to Savvy Senior, P.O. Box 5443, Norman, OK 73070; or visit savvysenior.org.