Medicare Blog

what if i dont want medicare extra help

by Mrs. Corine Larson Published 2 years ago Updated 1 year ago
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If you don’t qualify for Extra Help, these options may help you lower your prescription drug coverage costs: • Your state may have programs that can help pay your prescription drug costs. Contact your Medicaid office or State Health Insurance Assistance Program (SHIP) for more information.

You need to apply to find out. You can apply for Extra Help through Social Security or the Medicaid office in the state where you live. If you don't qualify, you'll have to start paying a monthly premium. If you don't make these payments, you may be disenrolled from your drug plan.

Full Answer

Are you eligible for Medicare extra help?

You are an American Indian or Alaska Native. If you have Medicaid or Supplemental Security Income (SSI), you are automatically included in the Extra Help program. Lots of Medicare enrollees are eligible for Extra Help, but many don’t know about the program or don’t apply.

Can I get Medicare extra help without Part D?

Remember that Extra Help is not a replacement for Part D or a plan on its own: You must still have a Part D plan to receive Medicare prescription drug coverage and Extra Help assistance. If you do not choose a plan, you will in most cases be automatically enrolled in one.

What if I don’t qualify for extra help?

If you don’t qualify for Extra Help, these options may help you lower your prescription drug coverage costs: • Your state may have programs that can help pay your prescription drug costs. Contact your Medicaid office or State Health Insurance Assistance Program (SHIP) for more information.

What happens if you don’t have Medicare?

There is no penalty for people who do not have Medicare. There is, however, a late-enrollment penalty if you who do not get Medicare when you are first eligible and then later change your mind and enroll. This penalty will tack on 10% to monthly Part B premiums (now $135.50 for most enrollees) for each full year you are late in enrolling.

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How do I get my $144 back from Medicare?

Even though you're paying less for the monthly premium, you don't technically get money back. Instead, you just pay the reduced amount and are saving the amount you'd normally pay. If your premium comes out of your Social Security check, your payment will reflect the lower amount.

Do Medicare benefits have to be repaid?

The payment is "conditional" because it must be repaid to Medicare if you get a settlement, judgment, award, or other payment later. You're responsible for making sure Medicare gets repaid from the settlement, judgment, award, or other payment.

Does Medicare Part B premium change every year based on income?

Remember, Part B Costs Can Change Every Year The Part B premium is calculated every year. You may see a change in the amount of your Social Security checks or in the premium bills you receive from Medicare. Check the amount you're being charged and follow up with Medicare or the IRS if you have questions.

What is the income limit for extra help in Michigan?

To qualify for Extra Help, your annual income must be limited to $20,385 for an individual or $27,465 for a married couple living together.

Is it necessary to have supplemental insurance with Medicare?

For many low-income Medicare beneficiaries, there's no need for private supplemental coverage. Only 19% of Original Medicare beneficiaries have no supplemental coverage. Supplemental coverage can help prevent major expenses.

Can I get Medicare Part B for free?

While Medicare Part A – which covers hospital care – is free for most enrollees, Part B – which covers doctor visits, diagnostics, and preventive care – charges participants a premium. Those premiums are a burden for many seniors, but here's how you can pay less for them.

How can I reduce my Medicare Part B premiums?

To request a reduction of your Medicare premium, contact your local Social Security office to schedule an appointment or fill out form SSA-44 and submit it to the office by mail or in person.

Does everyone pay a Medicare Part B premium?

Most people pay the standard Part B premium amount. If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you'll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

Does Social Security count as income for Medicare?

All types of Social Security income, whether taxable or not, received by a tax filer counts toward household income for eligibility purposes for both Medicaid and Marketplace financial assistance.

Why do doctors not like Medicare Advantage plans?

If they don't say under budget, they end up losing money. Meaning, you may not receive the full extent of care. Thus, many doctors will likely tell you they do not like Medicare Advantage plans because private insurance companies make it difficult for them to get paid for their services.

Do I need Medicare Part D if I don't take any drugs?

No. Medicare Part D Drug Plans are not required coverage. Whether you take drugs or not, you do not need Medicare Part D.

What is the income limit for Medicare in Michigan 2021?

Income eligibility: The income limit is $1,063 a month if single and $1,437 a month if married. Asset limits: The asset limit is $2,000 if single and $3,000 if married.

What is the number to call for Medicare?

1-800-557-6059 | TTY 711, 24/7. These programs include: Medicare Savings Programs. Extra Help. Medicaid. Programs of All-Inclusive Care for the Elderly (PACE) Take a look at some of these programs and find out if you’re eligible.

Who administers Medicare buy in programs?

These programs, also called Medicare Buy-In programs or Medicare Premium Payment Programs, are administered by the individual states in which they are offered and are available to people with limited income and resources.

What are the programs that help pay for out-of-pocket expenses?

Medicare Extra Help, Medicare Savings Programs, Medicaid and PACE. You may qualify for certain government and private programs that offer help paying for some of the out-of-pocket costs associated with Medicare. Take a look at some of these programs and find out if you're eligible. Original Medicare (Part A and Part B) helps make healthcare more ...

What is QMB extra help?

Extra Help offers additional assistance in paying for Medicare Part D prescription drug coverage.

How many types of Medicare savings programs are there?

There are four types of Medicare Savings Programs, each with its own qualifications and benefits. All help cover Medicare premiums and the associated out-of-pocket costs.

What is medicaid for?

Medicaid is a government assistance program available to those with limited incomes. It can be used alongside Medicare to help pay for health care expenses that aren’t covered by Original Medicare, such as personal and nursing home care services. Medicaid eligibility requirements vary by state.

Does SLMB reduce Medicare premiums?

This program reduces Medicare Part B premiums. Those who qualify for SLMB, are also automatically qualified for Extra Help.

How can I make sure I’m not covered by Medicare by mistake?

Question: I plan to continue working past age 65 and continue receiving health care benefits from my employer. I plan to keep making contributions to my health savings account (HSA), and I understand I should not sign up for any Medicare coverage, including Part A.

What is the penalty for late enrollment in Medicare?

This penalty will tack on 10% to monthly Part B premiums (now $135.50 for most enrollees) for each full year you are late in enrolling.

Do you have to notify Medicare of your intention to get Medicare?

You do not need to notify Medicare of your intention not to get Medicare. In fact, Medicare doesn’t even handle Medicare enrollments. Social Security does this work. I urge people who turn 65 to pay careful attention to their Social Security mail, because the agency occasionally does mistakenly enroll people in Medicare.

Does it hurt to sign up for Medicare online?

It also doesn’t hurt to sign up for a personalized online My Medicare account. This account includes your Part A and Part B status, and thus will reflect any improper enrollments.

Do you have life insurance when you retire?

Phil Moeller: From your question, it appears that you have retained life-long health insurance coverage from your employer during your retirements. If so, congratulations!

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The editors of Considerable.com determine the recommendations of products and services that appear in articles through rigorous reporting. If you buy a product from a retailer through a link on the site, Considerable.com may be paid a commission through our participation in an affiliate marketing program. These fees in no way affect our reporting or recommendations.

Is Medicare a conflict with HSA?

Phil Moeller: Your understanding of the HSA rules is correct. Having Medicare is a conflict with the tax-deductibility of HSAs.

What is Medicare Extra Help?

Extra Help is not insurance itself. It is a subsidy that lowers the cost of your drug coverage in Medicare Part D. With Extra Help, you will get the same coverage as anyone on the same plan, but you will pay less for it.

How much does extra help cover?

Depending on your situation, Extra Help will cover a portion of your drug costs or all of your drug costs. 1 This assistance can save you as much as $5,000 a year. 2. The Extra Help program only covers costs related to a Medicare prescription drug plan (Part D). It does not help with costs from other parts of Medicare (Part A, Part B, Part C, ...

What happens if you don't choose a prescription drug plan?

If you don’t choose a plan, Medicare will assign one to you randomly. Choosing your own drug plan allows you to get coverage sooner.

What is the extra help program?

The Extra Help program is sometimes called the Part D Low-Income Subsidy (LIS) program. That’s because it was created for people with limited financial resources.

What is the resource limit for extra help?

Common examples are your bank accounts, retirement accounts (IRAs, 401 (k)s), and any cash you have. Your home and vehicle are not counted. If you’re married, the resource limit for Extra Help is $29,160.

How long can you stay on the Extra Help program?

You can remain on the program for as long as you qualify. When you are on the Extra Help program, your status will be reviewed each year, usually in August.

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Content on this site has not been reviewed or endorsed by the Centers for Medicare & Medicaid Services, the United States Government, any state Medicare agency, or any private insurance agency (collectively "Medicare System Providers"). Eligibility.com is a DBA of Clear Link Technologies, LLC and is not affiliated with any Medicare System Providers.

What to do if you disagree with Medicare decision?

If you disagree with the decision we made about your eligibility for Extra Help, complete an Appeal of Determination for Extra Help with Medicare Prescription Drug Plan Costs. We also provide Instructions for Completing the Appeal.

Do you have to review your eligibility for extra help?

If you are already receiving Extra Help, we must review your eligibility periodically. We’ll ask you to complete the Review of Your Eligibility for Extra Help (SSA-1026B) to ensure you’re still eligible for Extra Help and receiving all the benefits you deserve.

Can you get help with Medicare?

With the Medicare Savings Programs (MSP), you can get help, from your state, paying your Medicare premiums. In some cases, MSPs may also pay Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) deductibles, coinsurance, and copayments if you meet certain conditions. If you qualify for certain MSPs, you automatically qualify ...

Can Medicare beneficiaries get extra help?

Table of Contents. Medicare beneficiaries can qualify for Extra Help paying for their monthly premiums, annual deductibles, and co-payments related to Medicare Part D (prescription drug coverage).

What is extra help?

Extra Help is a federal program that helps pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage. It is also known as the Part D Low-Income Subsidy (LIS).

Can you get extra help if your income is over the limit?

Even if your income or assets are above the eligibility limits, you could still qualify for Extra Help because certain types of income and assets may not be counted, in addition to the $20 mentioned above.

Is Extra Help a replacement for Medicare?

Remember that Extra Help is not a replacement for Part D or a plan on its own: You must still have a Part D plan to receive Medicare prescription drug coverage and Extra Help assistance. If you do not choose a plan, you will in most cases be automatically enrolled in one.

Can you get extra help with Part D if you have a late enrollment?

You should use Fall Open Enrollment during this time to make prescription drug coverage changes.) Eliminates any Part D late enrollment penalty you may have incurred if you delayed Part D enrollment. Depending on your income and assets, you may qualify for either full or partial Extra Help.

Can you get extra help if you have SSI?

If you are enrolled in Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program (MSP), you automatically qualify for Extra Help regardless of whether you meet Extra Help’s eligibility requirements.

When do you have to return Social Security extra help?

You must fill it out and return it to them within 30 days. If there are any adjustments to your Extra Help subsidy, they go into effect the following January. Adjustments that can be made are an increase, or a decrease in the amount of money, or termination of the subsidy. You have the right to appeal to the Social Security Administration if you do not agree with their decision.

When does Medicare review your eligibility?

The Social Security Administration reviews your eligibility status every year, generally at the end of August.

Does Social Security include income?

The Social Security Administration does not include the following as income:

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