Extra Help From Medicare
Medicare provides "extra help" to pay prescription drug costs for people who have limited income and resources. Resources include your savings and stocks, but not your home or car. If you qualify, you will get help paying for your plan's monthly premium and out-patient prescription drug copayments. Your premium generally will be lower if you receive extra help from Medicare.
People with limited income and resources may qualify for extra help one of two ways. The amount of extra help that you get will depend on your income and resources.
- You automatically qualify for extra help and don't need to apply. If you have full coverage from a state Medicaid program, get help from Medicaid paying your Medicare premiums (belong to a Medicare Savings Program), or get Supplemental Security Income benefits, you automatically qualify for extra help and do not have to apply for it. Medicare mails letters monthly to people who automatically qualify for extra help.
- You apply and qualify. You may qualify if your yearly income is less than $16,245 (single with no dependents) or $21,855 (married and living with your spouse with no dependents), and your resources are less than $12,510 (single) or $25,010 (married and living with your spouse). Resources include your savings and stocks but not your home or car. (If you live in Alaska or Hawaii, or pay at least half of the living expenses of dependent family members, income limits are higher.) These figures are for 2009 and may change in 2010.
To see if you qualify for getting extra help, call:
- 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7days a week.
- The Social Security Office at 1-800-772-1213, between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or
- Your State Medicaid Office
Best Available Evidence
If you believe you have qualified for extra help and you believe that you are paying an incorrect cost-sharing amount when you get your prescription at a pharmacy, our plan has established a process that allows you to either request assistance in obtaining evidence of your proper co-payment level, or, if you already have the evidence, to provide this evidence to us. For additional information, please contact CHP Member Services at one of the numbers listed on this page or see the link below for "Best Available Evidence."
