Saving Money on Prescriptions
If you receive Medicare benefits and have limited income and assets you may qualify for assistance with the costs of your prescription drugs through the Low Income Subsidy (also known as the Extra Help program).
Who qualifies?
Some people automatically receive the Low Income Subsidy. This includes:
- People who are enrolled in both Medicaid and Medicare;
- Those receiving Supplemental Security Income (SSI);
- Those who qualify for a Medicare Savings Program.
If you receive benefits from these programs, you do not need to apply for the Low-Income Subsidy- you’ll be enrolled automatically.
If you are not already enrolled in one the benefits programs noted above, you can apply for the Low-Income Subsidy through Social Security (online at ssa.gov or by phone at 1-800-772-1213 ) or by calling SHIIP-SMP at 1-800-351-4664.
What are the benefits of the Low Income Subsidy?
Most people who qualify will:
- Pay no premiums for their drug plan,
- Have no drug plan deductible,
- Pay no more than $12.15 for each brand-name drug the plan covers and $4.90 for generic
In addition to lower out-of-pocket costs, the Low Income Subsidy also offers the following protections:
- Each month you can switch to a new Prescription Drug Plan, or if you are in a Medicare Advantage Plan you can leave that to return to Original Medicare. This means you don't have to wait for Open Enrollment (Oct. 15 – Dec. 7) to change plans. Any plan changes made outside the Open Enrollment Period will become valid the following month. This is especially helpful if you need to start medications that are not on your current plan’s formulary (approved drug list).
- There is no Part D late enrollment penalty, even if you enroll late (that is, after you were first eligible to join a Part D plan and did not have other drug coverage).