Extra Help Program may Benefit Low Income Medicare Part D Participants

October 22nd 2005

There may be benefits to the Medicare Part D drug coverage program.  Because of the out-of-pocket costs with the new Medicare prescription program Part D, Medicare has already sent letters to people who might be eligible for financial assistance.  

The extra assistance program is called “Extra Help”.  If your resources are less than $11,500 (single) or $23,000 (married) you may qualify for extra help paying for Medicare Prescription Drug Coverage. You can fill out an online application for Extra Help.

The financial assistance available through Extra Help is for low and moderate income individuals.  Medicaid eligible individuals on Medicare can receive the benefits if they apply for “Extra Help”. 

There will be no monthly premiums or annual deductibles and co-pays are very low.  For generic drugs the co-pay is $1 and the co-pay for brand name drugs is $3.  The maximum out of pocket cost is $3,600. After the $3,600 is reached, Medicare will pay all drug costs. 

There are other out of pocket programs for levels of “poverty”.  A 1 person household earning less than $798 per month is considered poverty while a 2 person household earning less than $1,070 is considered impoverished.    

Other out-of-pocket programs exist for beneficiaries above 135% of the poverty level with assets below $6,000 for a single person and $9,000 for a couple.  The co-pays for this program are $2 and $5 for generics and name brands respectively.

There is another program for beneficiaries below 150 percent of the poverty level with assets of $11,500 and $23,000 for single and couples respectively. The monthly premium is based on a sliding scale and there is a $50 deductible.  After the deductible the beneficiary pays 15% of the cost up to $5,100. After the $5,100 is reached the beneficiary pays $2 and $5 for generics and name brand drugs respectively.

Plan D, according Dan Rohan a columnist for Senior Focus, this is a good plan if you spend less than $2200 per year or more than $5,100 per year on prescription plan.    

A list of Poverty Guidelines with levels is available at Medicare.  This chart is used for all the states except Alaska and Hawaii.  If you click on the links and they do not load it is probably because you do not have a pdf reader. This can be found for download here.   

By Dan Wilson
Best Syndication Staff Writer

Medicare Books

Keywords and misspellings:  Medicare Medecare Medicair Medicaire plan d