Social Security & Medicare Questions: June 2011

Social Security & Medicare Questions: June 2011

Q: Last year I filled out all the paper work to get financial assistance with my prescriptions. After hours of filling out and research for it, I was told I received $50 too much. Now, I have received the paper work in the mail to fill it all out again, and apply again. Even though I am below the poverty level and could really use the financial help, will it do any good to fill this out again? I still have the same $50 too much.

A: Yes by all means reapply. The Medicare Part D “Extra Help” program for assistance with prescription costs is estimated to be worth $4,000, so even if you do spend a few hours getting documents together where else would you get that kind of return for your time?

Extra Help can provide assistance for monthly premiums, annual deductibles, and copayments. In addition, the program provides valuable coverage for the doughnut hole coverage gap — coverage that’s getting hard-to-find and afford when you do locate a plan that offers some coverage.

If your income is below the federal poverty guidelines then you should qualify for Extra Help as long as your “resources” or savings meet the limits. To qualify, your savings, bank accounts, stocks and bonds must be limited to $12,640 for an individual or $25,260 for a married couple. Your home, car and any life insurance policy are NOT counted as resources.

Your income must be limited to $16,335 for an individual or $22,065 for a married couple. The income calculation includes your gross Social Security benefits (before deductions for Medicare premiums and other adjustments) as well as any earnings, pensions, or other sources of income. Even if your income is slightly higher than the limit, you should still apply, because you may be able to qualify on a sliding scale for at least some help.

You did not say in what way you have $50 too much. Is that in income or savings? If your resources or savings are too high, perhaps you can lower your savings until you are within the limits. If you receive other income in addition to your Social Security benefits, perhaps there’s a way you could reduce your income by $50 in order to qualify. You will need to determine if what you’re spending on prescriptions would be worth the trade - off.

You can apply online at, or call Social Security at 1-800-772-1213. However, since your first application was rejected, there’s a chance that you may have filled out your application incorrectly. I would recommend getting some advice and assistance in applying for the program. One of your best resources is your State Health Insurance Assistance Programs (SHIP). You can get free one-on-one counseling to help you apply. Check your local phone book for the agency on aging or senior services department in your area. Remember: if you do qualify for Extra Help, you still need to enroll in a Part D plan to actually get the benefit.