Note: The resource limits in the table above do not include the $1,500 per person burial exclusion. Therefore you would reduce your resources by $1,500 per person.
If you live in Alaska or Hawaii, or pay more than half of the living expenses of dependent family members, income limits are higher. Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa have their own rules for providing extra help to their residents. See "Programs for People who live in the U.S. Territories of Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa
" for more information.
What happens if I automatically qualify for extra help?
Medicare mails letters to people who automatically qualify for extra help and don't need to apply for it. If you get one of these letters, keep it for your records. You still need to join a Medicare drug plan to get Medicare prescription drug coverage. If you don't join a Medicare drug plan, Medicare will enroll you in one to make sure you don't miss a day of coverage. Check to see if the plan Medicare enrolled you in covers the drugs you use and if you can go to the pharmacies you prefer. If not, you can change plans.
If Medicare enrolls you in a plan, Medicare will send you a letter letting you know when your coverage begins. If you don't want to join a Medicare drug plan (for example, because you want to keep your employer or union coverage instead), you can call 1-800-MEDICARE (1-800-633-4227) or the plan listed in your letter and tell them you don't want to be in the Part D plan. You must be in a Medicare drug plan to get this extra help.
What If you didn't automatically qualify, but think you might qualify for extra help
Here's what to do:
- Apply for extra help. Call Social Security at 1-800-772-1213, visit www.socialsecurity.gov on the web, or apply at your State Medical Assistance (Medicaid) office (see 1-800-MEDICARE Helpline). TTY users should call 1-800-325-0778. After you apply, you will get a letter in the mail letting you know if you qualify and what to do next. Even if you don't qualify, you should consider joining a drug plan.
- Join a Medicare drug plan. If you apply and qualify for extra help, you can either join a plan on your own or let Medicare enroll you in a plan. Medicare will send you a letter letting you know what plan it will enroll you in and when your coverage begins. If Medicare enrolls you in a drug plan, you can switch plans at least once through the end of the calendar year. You can also switch plans one time between October 15 and December 7 in following years. Your coverage would begin January 1 of the following year.
Call 1-800-MEDICARE (1-800-633-4227) or your State Health Insurance Assistance Program
(see Other Important Medicare Contacts
for their telephone number) to get answers to your questions about extra help paying for your prescription drug costs. TTY
users should call 1-877-486-2048.