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I should be getting "Extra Help", but I am not. What should I do to get my benefits?

Category: Medicaid, LIS, & Extra Help
Updated: Aug, 31 2022


It is our understanding that it sometimes takes a month for your low-income subsidy or Medicare Part D Extra Help information to be sent to your Medicare Part D plan provider from Medicare/Medicaid.

Once this information is received and processed by your Medicare plan provider (and only when it is sent from Medicare/Medicaid) will your premium be reduced.  Also, the difference in the premium and cost-sharing you have paid and your subsidized amounts (retroactive back to the month of your subsidy effective date) will be returned to you.

If you have a letter stating the exact co-pays, you can send this letter to your Medicare Part D plan provider and they may at least change your co-pay in their pharmacy system.

You can call your Medicare Part D plan's Member Services department to ask if they will accept your subsidy letter to adjust your co-payments or if they will only accept the information when received directly from Medicare/Medicaid.

We have the telephone number for most Member Services departments online, just click on the plan’s name when using our Medicare Advantage Plan Finder or MA-Finder (enter your ZIP to begin) or our stand-alone Medicare Part D Plan Finder or PDP-Finder (choose your state to begin).

If more than a month or two has passed since you received your subsidy letter and your Medicare Part D plan provider still has not received your subsidy information from Medicare, please contact your local Social Security office or call Medicare at 1-800-633-4227 and choose to speak with a representative.






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