How to apply for Extra Help with Prescription drug coverage?

Extra Help, also known as the State and federal Low Income Subsidies (LIS) program is a Medicare program that helps people with limited income and resources pay for their Medicare prescription drug costs. Here's how you can apply for Extra Help:

1. Apply online: You can apply for Extra Help online by visiting the Social Security Administration's (SSA) website at https://www.ssa.gov/benefits/medicare/prescriptionhelp/. Follow the instructions to complete the application.

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2. Call the Social Security Administration: You can call the SSA at 1-800-772-1213 (TTY 1-800-325-0778) to apply over the phone. Representatives are available Monday through Friday, from 7 a.m. to 7 p.m.

3. Apply in person: You can visit your local Social Security office and apply in person. To find your local office, visit the SSA website at https://secure.ssa.gov/ICON/main.jsp.

Can someone apply for the LIS program and still use Medicare Advantage Part C?

Yes, individuals can apply for and receive the Low-Income Subsidy (LIS) program, also known as Extra Help, while still using a Medicare Advantage plan (Part C). Medicare Advantage Part C often include prescription drug coverage (Part D) as part of their benefits package, and this prescription drug coverage can be combined with the LIS program. Here's how it works:

1. Medicare Advantage with Prescription Drug Coverage (MAPD): Medicare Advantage plans that include prescription drug coverage are known as MAPD plans. These plans offer all the benefits of Original Medicare (Part A and Part B) along with prescription drug coverage. Individuals enrolled in a MAPD plan receive both medical and prescription drug benefits through a single plan.
2. LIS Application: If you have a Medicare Advantage plan and believe you may be eligible for the LIS program due to your low income and limited resources, you can still apply for Extra Help. The LIS program can help reduce your out-of-pocket costs for prescription medications, even if you have a Medicare Advantage plan with drug coverage.
3. Benefits of Combining LIS with Medicare Advantage: If you qualify for the LIS program, it can help cover Part D premiums, reduce drug copayments and coinsurance, and eliminate or reduce the coverage gap (donut hole) costs associated with your coverage for prescription drugs within the Medicare Advantage plan.
4. Annual Review: Keep in mind that LIS eligibility is reviewed annually, and changes in your income or resources can affect your eligibility status. Make sure to update your information with the Social Security Administration (SSA) or your state Medicaid office to maintain your eligibility for Extra Help.

It's important to note that the LIS program primarily pertains to Medicare Part D prescription drug coverage, so if you have a Medicare Advantage plan with drug coverage, you can still benefit from Extra Help to make your prescription medications more affordable. When applying for Extra Help, you will need to provide information about your income, resources, and current prescription drug coverage. You may also need to provide documentation, such as proof of income, bank statements, or investment records.

If you are eligible for Extra Help, you may be able to get help paying for your monthly premiums, annual deductibles, and prescription co-payments. You may also be eligible for a Special Enrollment Period (SEP), which allows you to enroll in or switch Medicare Part D plans outside of the regular enrollment periods.