Medicare Blog

where to find the form to get extra help with rx from medicare

by Lori Schuster Published 2 years ago Updated 1 year ago

Applying for Extra Help with Medicare To apply for Extra Help, you can fill out Form SSA

Social Security Administration

The United States Social Security Administration is an independent agency of the U.S. federal government that administers Social Security, a social insurance program consisting of retirement, disability, and survivors' benefits. To qualify for most of these benefits, most workers pay Social …

-1020 on the Social Security website. You can also call Social Security to apply over the phone or visit your local Social Security office to apply in person.

When needed, a paper Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020) can be obtained by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

Full Answer

How do I apply for extra help with Medicare prescription drug costs?

How do I apply? Applying for Extra Help is easy. Just complete Social Security’s Application for Extra Help with Medicare Prescription Drug Plan Costs (Form SSA-1020). Use one of these methods: Apply online at www.ssa.gov/extrahelp. Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to apply over the phone or to request an application.

What is the Medicare extra help program?

These state programs provide help with other Medicare costs. Social Security will send 10 information to your state unless you tell us not to on the Extra Help application. Your state will contact you to help you apply for a Medicare Savings Program.

How do I apply for extra help?

You can also call Social Security to apply over the phone or visit your local Social Security office to apply in person. Social Security will mail a letter to you, informing you of whether you qualify for Extra Help.

How do I know if I qualify for Medicare extra help?

A purple notice from Medicare that says you automatically qualify for Extra Help. A yellow or green automatic enrollment notice from Medicare. An Extra Help "Notice of Award" from Social Security. An orange notice from Medicare that says your copayment amount will change next year.

What is a 1021 form?

WHEN TO USE THIS FORM: Use Form SSA-1021 to appeal Social Security's determination regarding eligibility or continuing eligibility for Extra Help with your Medicare prescription drug plan costs.

How does Medicare Part D Extra Help work?

Extra Help is a program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance. If you qualify for Extra Help, you won't pay a late enrollment penalty when you join a Medicare drug plan.

What is Form SSA 1020 OCR SM?

Form SSA-1020B-OCR-SM-INST (01-2014) Recycle prior editions. Social Security Administration. Important Information. You may be eligible to get Extra Help paying for your prescription drugs. The Medicare prescription drug program gives you a choice of prescription plans that offer various types of coverage.

Is Lis the same as 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).

How do you qualify for $144 back from Medicare?

How do I qualify for the giveback?Are enrolled in Part A and Part B.Do not rely on government or other assistance for your Part B premium.Live in the zip code service area of a plan that offers this program.Enroll in an MA plan that provides a giveback benefit.

What is the income limit for extra help in 2021?

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.

What is a CMS notice?

CMS model notices contain all of the elements CMS requires for proper notification to enrollees or non-contract providers, if applicable. Plans may modify the model notices and submit them to the appropriate CMS regional office for review and approval. Plans may use these notices at their discretion.

Does Medicare send letters?

These letters confirm actions you took (or you asked us to do for you) regarding your secure Medicare account. We send letters when you: Create your new account (or ask us to create your account) Ask us to reset your password.

Is Medicare Savings notice legitimate?

Social Security sends out letters to beneficiaries at certain times of the year. For example, in May they sent out letters to beneficiaries who may qualify for a Medicare Savings Program and/or the Medicare Part D's low-income subsidy program, known as Extra Help. These letters are legitimate.

What does Lis mean in Medicare?

Low Income SubsidyThe Low Income Subsidy (LIS) helps people with Medicare pay for prescription drugs, and lowers the costs of Medicare prescription drug coverage.

How do I apply for LIS in California?

You may also apply for LIS by phone (1-800-772-1213) or on the Social Security website. The LIS program has several different levels of subsidy. If your income is higher, between 135-150% of the FPL, you may receive a partial subsidy.

What is a Lis plan?

Medicare. The Low-Income Subsidy (LIS) is a Medicare program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance. The Low-Income Subsidy (LIS) is also known as Extra Help.

What are some examples of documents you can send to Medicare?

Examples of documents you can send your plan include: A purple notice from Medicare that says you automatically qualify for Extra Help. A yellow or green automatic enrollment notice from Medicare. An Extra Help "Notice of Award" from Social Security. An orange notice from Medicare that says your copayment amount will change next year.

What is extra help?

Extra Help is a program to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance. If you get Extra Help but you’re not sure if you're paying the right amount, call your drug plan.

How much does a prescription cost for 2021?

Make sure you pay no more than the LIS drug coverage cost limit. In 2021, prescription costs are no more than $3.70 for each generic/$9.20 for each brand-name covered drug for those enrolled in the program. Contact Medicare so we can get confirmation that you qualify, if it's available.

What is a copy of a medicaid card?

A copy of your Medicaid card (if you have one). A copy of a state document that shows you have Medicaid. A print-out from a state electronic enrollment file that shows you have Medicaid. A screen print from your state's Medicaid systems that shows you have Medicaid.

How long does it take to get a prescription for a syringe?

Your request can take anywhere from several days to up to 2 weeks to process, depending on the circumstances. Call us at 1-800-MEDICARE (1-800-633-4227). TTY: 1-877-486-2048. Be sure to tell your plan how many days of medication you have left.

What is an orange notice from Medicare?

An orange notice from Medicare that says your copayment amount will change next year. If you have. Supplemental Security Income (Ssi) A monthly benefit paid by Social Security to people with limited income and resources who are disabled, blind, or age 65 or older.

How long does Medicaid pay for stay?

Or, a copy of a state document showing Medicaid paid for your stay for at least a month. A print-out from your state’s Medicaid system showing you lived in the institution for at least a month. A document from your state that shows you have Medicaid and are getting home- and community-based services.

What is extra help for Part D?

Getting Extra Help with your Part D can: Eliminate the coverage gap, also known as the donut hole. This means your prescriptions won’t cost more just because you went over a spending limit in a particular year. On average, Extra Help is estimated to save beneficiaries $5,000 in these costs per year.

How much does extra help save?

On average, Extra Help is estimated to save beneficiaries $5,000 in these costs per year. If you’re eligible for Medicaid or any of the following Medicare Savings Programs, you automatically qualify for Extra Help. Qualified Medicare Beneficiary (QMB)

How much does a generic prescription cost?

For those enrolled in Extra Help, generic prescription costs are no more than $3.60 each, and brand-name prescription costs are no more than $8.95 each. If you didn’t enroll in Part D when you first became eligible, you won’t have to pay the late enrollment penalty if you have Extra Help.

What is the income limit for extra help in 2021?

What Are the Income and Resource Limits for Extra Help in 2021? In 2021, the annual income limit for Extra Help for an individual is $19,140. For a married couple who is living together, the limit is $25,860. When your income is calculated, governmental assistance such as food stamps, housing assistance, and home energy assistance aren’t counted.

Can you mail a color coded document to Medicare?

You can mail your color-coded document to your Part D plan to help verify the level of Extra Help for which you qualify. Those who are dual-eligible to receive Medicare and Medicaid qualify for full Extra Help.

Is food stamps counted as extra help?

When your income is calculated, governmental assistance such as food stamps, housing assistance, and home energy assistance aren’t counted. Even if your income is higher than the limits, you should still apply for Extra Help if you think you qualify. Some scenarios where you’d still be eligible for Extra Help even though your income is over ...

How to check if you qualify for medicaid?

If you aren't getting Extra Help, find out if you qualify by calling: 1 1-800-Medicare (toll-free; TTY/TDD users call 1-877-486-2048), 24 hours a day/7 days a week 2 Your State Medicaid Office 3 The Social Security Administration toll-free at 1-800-772-1213. TTY/TDD users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday. 4 Get more information about qualifying for Extra Help.

What is the number to call for Social Security?

If you aren't getting Extra Help, find out if you qualify by calling: The Social Security Administration toll-free at 1-800-772-1213. TTY/TDD users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.

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