Extra Help (Health Care): Your Guide to Medicare Prescription Support

Definition & Meaning

Extra help is a program under Medicare designed to assist individuals with limited income and resources in covering the costs associated with Medicare prescription drug plans. This financial aid helps pay for various expenses, including premiums, deductibles, and coinsurance. To qualify for extra help, individuals must meet specific income and resource limits: a single person must have resources below $11,710, while a married couple must have resources below $23,410.

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Real-world examples

Here are a couple of examples of abatement:

Example 1: A 70-year-old woman with a monthly income of $1,500 and savings of $8,000 applies for extra help. She qualifies due to her income and resource levels being below the thresholds.

Example 2: A married couple, both aged 65, with a combined income of $3,000 and total resources of $20,000, applies for extra help. They also qualify based on their financial situation.

State-by-state differences

Examples of state differences (not exhaustive):

State Income Limit Resource Limit
California $20,000 $11,710
Texas $20,000 $11,710
New York $20,000 $11,710

This is not a complete list. State laws vary, and users should consult local rules for specific guidance.

Comparison with related terms

Term Definition Key Difference
Medicare Savings Program A program that helps pay for Medicare premiums and other costs. Extra help focuses specifically on prescription drug costs.
Medicaid A state and federal program providing health coverage for low-income individuals. Medicaid is broader, covering various health services beyond prescriptions.

What to do if this term applies to you

If you believe you qualify for extra help, start by gathering your financial documents, including income statements and resource information. You can apply online through the Social Security Administration's website or use the forms available on US Legal Forms for assistance. If your situation is complex or you need further guidance, consider consulting a legal professional.

Quick facts

  • Income limit: $20,000 for individuals; $40,000 for couples.
  • Resource limit: $11,710 for individuals; $23,410 for couples.
  • Helps cover Medicare Part D costs.

Key takeaways