Medicare has a program that helps pay for your prescription medicine. It's called Medicare Prescription Drug Coverage or Medicare Part D. This program gives you a choice of prescription plans that offer various types of coverage. If you have enrolled or can enroll in Medicare Part D and you have limited income and resources, you may be able to get "Extra Help" with your prescription drug costs. This benefit is known as Medicare Part D Low-Income Subsidy (LIS) or Extra Help. Depending on your income and resources, you will have low or no deductible, low or no premiums, no coverage gap (also called the "doughnut hole"), and will pay much less for your prescriptions. Extra Help can provide you an average value of $4,900 per year. However, to get Extra Help, you must be enrolled in a Medicare Prescription Drug plan.
If you have Medicare and have limited income and resources, you may be able to get Extra Help paying for your prescription drug costs if:
- Your income is less than $19,380 if single and $26,100 if married. If you live in Alaska or Hawaii, you may still get help even if your income is higher than these limits.
- You have resources less than $14,610 if single and $29,160 if married.
Use the information below to find out more about the Extra Help program and how to use this online application.
How Can I Get Medicare Part D Low-Income Subsidy (LIS)/Extra Help?
To get Extra Help with Medicare prescription drug costs, you must complete and submit this application. The Social Security Administration (SSA) will review your application and send you a letter to let you know if you qualify for Extra Help. SSA will also send you information about the Medicare Prescription Drug Coverage and tell you what you should do next.
NOTE: To apply, you must live in one of the 50 States or the District of Columbia.
Who Should Apply for Extra Help?
You should complete this online application for Extra Help if:
- You have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Supplementary Medical Insurance); and
- You live in one of the 50 states or the District of Columbia; and
- Your income is below $18,735 if you are not currently married or not living with your spouse, or $25,365 if you are currently married and living with your spouse; and
- Your combined savings, investments, and real estate are not worth more than $14,610 if you are not currently married or not living with your spouse, or $29,160 if you are currently married and living with your spouse. (DO NOT include the home you live in, vehicles, personal possessions, life insurance, burial plots, irrevocable burial contracts or back payments from Social Security or SSI.)
If you have more than those amounts, you may not qualify for the Extra Help. However, you can still enroll in an approved Medicare prescription drug plan for coverage.
Who Should Not Apply for Extra Help?
You should not complete this online application if:
If you are in one of the 3 groups above, you will automatically get the Extra Help and do not need to apply.
- You receive Medicaid and have Medicare, or
- Your State pays for your Medicare premiums (Medicare Savings Program), or
- You receive Supplemental Security Income (SSI) payments and have Medicare.
Will This Application Enroll Me in a Medicare Prescription Drug Plan?
This is an application for Extra Help with Medicare prescription drug costs. It does not enroll you in a Medicare prescription drug plan
. To get that coverage, you will have to enroll directly with an approved Medicare prescription drug plan. If you need information about Medicare Prescription Drug plans or how to enroll in a plan, call Medicare's toll-free number 1-800-MEDICARE
(1-800-633-4227) (TTY 1-877-486-2048)
or visit www.medicare.gov
Can I Get Help If I Don't Have a Medicare Prescription Drug Plan?
If you are found eligible for Extra Help and you have not yet enrolled in a Medicare Prescription Drug plan (Medicare Part D), you may temporarily get prescription drug coverage through Medicare's Limited Income NET (LI NET) Program. This program was created by Centers for Medicaid and Medicare Services (CMS) to eliminate gaps in prescription drug coverage for low-income Medicare Beneficiaries. The LI NET program is temporary and can only help you for a short time (usually about 2 months). If after this time, you have not chosen a Medicare Part D plan, CMS will automatically enroll you into one. For more information about LI NET, go to: www.Humana.com/LINET
or call (800) 783-1307.
Can I Get Help With Other Medicare Costs?
You may be able to get help from your State with other Medicare costs under the Medicare Savings Programs. These programs can save you up to $135.50 per month. By completing this online application for Extra Help, you will start the application process for a Medicare Savings Program. SSA will send information from your Extra Help application to your State, unless you tell SSA not to when you complete this form. Someone from your State will contact you to help you complete your Medicare Savings Program application.
How Does the Online Application Work?
This application should be completed in one session. You will not be able to save an incomplete application.
When you have completed your application, you will get a full summary of the information you entered. If you make a mistake, you can change your answers before you submit your application. After you submit the application electronically, you will be able to print a receipt. You will also be able to view other programs you may be eligible for based on the information you entered in the application. These other programs can save you money on health-care expenses, provide financial help, and more.
Here is what you will need to know before using this online application:
- Select "Next" to move forward. This option is located at the bottom of the page. Do NOT use the Back button on your browser to move backward.
- You must complete all required information before you can submit the application.
- If you need help, click on the "Need Help?" link on the top right hand corner of the page to receive answers to general questions about filling out the application. To go back to your application, you can click on either one of the "Back" buttons located on the top and bottom of the page. To get help with a particular question, click on the "HELP" link located at the end of each question. The help will appear below the question, click on "HELP" again to make the help text disappear.
- Different Internet browsers (and even different versions of the same browser) work in different ways. A list of keyboard commands, hotkeys, or access keys specific to your browser can be found in the Help section of your browser. The Help feature can be located on the Menu bar of your browser or by using the F1 function key on the keyboard.
There are time limits for your work on each page. After 45 minutes on a page, you must go to another page or your application session will end, and your work will be lost.
How Long Do I Have To Answer Questions on Each Page?
For security reasons, there are time limits on each page. After 45 minutes on a page, you must go to another page or your application session will end, and your work will be lost.
What Information Do I Need Before I Start My Application?
To find out if you could be eligible for Extra Help with Medicare prescription drug costs, Social Security needs information about your (and your spouse's, if you are married and living together) income and resources. Documents that may help you prepare include:
- Social Security card;
- bank account statements, including checking, savings, and certificates of deposit (CDs);
- Individual Retirement Accounts (IRAs), stocks, bonds, savings bonds, mutual funds, other investment statements;
- tax returns;
- payroll slips; and
- your most recent Social Security benefits award letters or statements for Railroad Retirement benefits, Veterans benefits, pensions and annuities.
If you do not have these documents, provide us with your best estimate so that Social Security can tell you whether you are likely to qualify for Extra Help with your Medicare prescription drug costs. You need this information only to help you complete the application. You should not have to submit the documents unless someone from Social Security contacts you.
Will I Be Able to Edit My Information Before I Submit My Application?
When you have completed the application, you will get a full summary of the information you entered. You can make changes if necessary before you submit your application. After you submit the application electronically, you will be able to print or save a receipt for your submitted application.
When Can I Submit My Application?
This service is available during the following hours (Eastern Time):
Monday through Friday: 5:00 AM - 11:00 PM
Saturday: 5:00 AM - 9:00 PM
Sunday: 8:00 AM - 8:00 PM
Holidays: 5:00 AM - 9:00 PM
Social Security accepts applications during certain hours. We recommend that you begin at least one hour before the latest time listed above to ensure your application will be processed.
Can I Get Help Completing This Application?
If you need help completing this application, click here
to find a local agency in your community, or call Social Security toll-free at 1-800-772-1213 (TTY 1-800-325-0778)