Do your clients need extra help paying for their Medicare prescription coverage? Make sure they know about Low Income Subsidies, often called Extra Help, which can help Medicare enrollees with their costs. The Low Income Subsidy resource limits for 2020 have been announced, so this is a great time to remind your clients about this important source of financial assistance.
Explaining Extra Help
Extra Help Low Income Subsidies can help Medicare enrollees pay for various prescription costs, including premiums, deductibles and copays. The Social Security Administration says that Extra Help is worth about $4,900 each year. That’s a lot of money that your clients don’t want to leave on the table.
Qualifying for Extra Help
To receive Extra Help, your clients will have to meet a few qualifications.
- They must be enrolled in Medicare.
- They must live in one of the 50 states or in the District of Columbia.
- They must meet the resource and income limits.
When calculating resources, you clients should include bank accounts, stocks and bonds, but they should not include life insurance policies, their car or their home. Additionally, if some of their resources are intended for burial expenses, they can make use of a burial expense allowance.
The resource limits have been announced for 2020:
- $7,860 for a single individual for the full subsidy without the burial expense allowance and $9,360 with it
- $11,800 for a married couple for the full subsidy without the burial expense allowance and $14,800 with it
- $13,110 for a single individual for a partial subsidy without the burial expense allowance and $14,610 with it
- $26,160 for a married couple for a partial subsidy without the burial expense allowance and $29,160 with it
Applying for Extra Help
If your clients qualify for Extra Help automatically, they will receive a notification informing them of this. Otherwise, they can apply for Extra Help online at through the Social Security Administration by going to https://www.ssa.gov/benefits/medicare/prescriptionhelp/.
Using Extra Help
Once your clients have qualified for Extra Help, they should make sure they are receiving the financial assistance correctly. They will need to enroll in a Medicare prescription drug plan. They should also contact their plan to notify them of the Low Income Subsidy, and they may need to supply documentation to prove this.
In 2020, Medicare enrollees receiving Extra Help should not pay more than $3.60 for generic prescriptions or $8.95 for brand-name prescriptions that are covered by their plan. If they think they are paying more than they should, they should contact the plan.
