Do You Need Help Paying for Your Prescriptions?
Do you ever have difficulty paying for your prescription drugs? Do you
have limited income and assets? If you answered “yes” to either of these questions and
you are a person with Medicare, Extra Help may be available for you.
The federal Low-Income Subsidy (LIS) program, also known as Extra Help, assists
qualified Medicare beneficiaries with out-of-pocket expenses associated with Medicare
Part D prescription drug expenses. There are more than 70,000 Medicare beneficiaries
in North Carolina who may be eligible for this program but have yet to apply. The
Seniors’ Health Insurance Information Program—or SHIIP— is a division of the N.C.
Department of Insurance that can help beneficiaries understand and apply for this
“Many Medicare beneficiaries are not aware that this assistance program is available to
them,” said Insurance Commissioner Wayne Goodwin. “SHIIP can help people with
Medicare understand what they may be qualified to receive.”
To qualify for Extra Help, a Medicare beneficiary must meet certain income, resource
and asset level requirements. The income and asset limits for Extra Help are $1,471.25
per month with assets up to $13,640 if you are single, and $1,991.25 per month with
assets up to $27,250 if you are married.
Income includes monthly earnings, Social Security and Veterans’ benefits, disability
payments, cash contributions, retirements and pensions. Resources and assets include
the value of items that the person owns, such as cash, stocks, bonds, retirement
accounts, the value of a second car, boats and any real property that is not the primary
residence and does not produce income. Resources do not include appliances and
other household furnishings, clothing or other personal items, such as jewelry. Assets
excluded from the evaluation process are a home, all property attached to the home,
personal belongings, one vehicle and irrevocable burial contracts and plots.
Individuals who qualify for these programs will receive Extra Help with their Medicare
Part D prescription drug plans at the 100 percent level. This means they will pay a
reduced co-pay of $2.65 for generic drugs and $6.60 for name-brand drugs, as well as
lower monthly premiums.
When you apply for Extra Help through Social Security’s website, you can also choose
the option to apply for Medicare Savings Programs during the online application
process. The SHIIP office can assist you with applying online for the Extra Help
program and, subsequently, the Medicare Savings Programs through the Social
Security Administration website at www.socialsecurity.gov. Medicare beneficiaries may
also apply online themselves or by contacting the Social Security Administration at 1-
800-772-1213, or with the help of a SHIIP volunteer at 252-527-2191.
SHIIP, a division of the North Carolina Department of Insurance, has volunteers in all
100 counties in North Carolina who offer one-on-one counseling and provide free,
unbiased information about Medicare, Medicare supplements, Medicare Part D,
Medicare Advantage and health plan options and long-term care insurance. To contact
SHIIP, call 1-855-408-1212 or visit www.ncshiip.com. In Lenoir County SHIIP operates out of Lenoir County Cooperative Extension. Call 252-527-2191 for more information about Medicare or to become a SHIIP volunteer.