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SOCIAL SECURITY APPLICATION
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- What is Extra Help?
- How to qualify for Extra Help
- How to apply
- What happens after you apply
- Late enrollment penalty
- Why apply online?
- State agencies help with Medicare cost
- Medicare Savings Program
- Medicaid and medical assistance
- Long Term Medicaid
- Medicaid for people with SSI
- What’s the difference?
- Monthly limits and resources
WHAT IS Extra Help?
Anyone who has Medicare can get Medicare prescription drug coverage. Some people with limited resources and income may also be able to get Extra Help to pay for the costs- monthly premiums, annual deductibles and prescription co-payments.
Many people qualify for these important savings and don’t even know it.
HOW TO QUALIFY for Extra Help?
- Must reside in one of the 50 states or the District of Columbia.
- Resources must be limited to $14,610 for an individual or $29,160 for a married couple living together. Resources include such things as bank accounts, stocks and bonds. They do not count your home, car or any life insurance policy as resources.
- Note: Life insurance is not counted toward Low Income Subsidy but if it has cash value it would be counted toward Medicaid resources.
- Annual income must be limited to $19,140 for an individual or $25,860 for a married couple living together.
- Even if income is higher, still may be able to get some help.
How to APPLY
- Complete Social Security’s application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020).
- Apply online at www.ssa.gov/extrahelp
- Call Social Security at 1-800-772-1213 to apply over the phone or to request an application
- Apply at your Social Security office
WHAT HAPPENS AFTER you apply?
- Social Security will review the application and send a letter to let you know if you qualify for Extra Help.
- Once you qualify, you can choose a Medicare prescription drug plan.
- If you don’t select a plan, the Centers for Medicare & Medicaid Services will do it for you.
- If you aren’t eligible for Extra Help, you still may be able to enroll in a Medicare prescription drug plan.
Late Enrollment PENALTY
- Medicare Prescription Drug Plan Penalty
- If you don’t enroll in a Medicare prescription drug plan when you’re first eligible, you may pay a late enrollment penalty if you join a plan later. You’ll have to pay this penalty for as long as you have Medicare prescription drug coverage.
- However, you won’t pay a penalty if you get Extra Help or another eligible prescription drug plan coverage.
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SOCIAL SECURITY APPLICATION
WHY apply online?
- The online application is secure and offers several advantages.
- It takes you through the process step-by-step with a series of self-help screens.
- The screens will tell you what information you need to complete the application and will guide you in answering the questions fully.
- You can apply from any computer
- You can start and stop at any time during the process.
- It will protect your personal information.
STATE AGENCIES HELP with Medicare cost
- When you file your application for Extra Help, you also can start your application process for the Medicare Savings Programs.
- State programs provide help with other Medicare costs.
- Social Security will send information to your state unless you tell them not to on the Extra Help application.
- Your state will contact you to apply for Medicare Savings Program.
MEDICARE SAVINGS Program
- The Medicare Savings Programs help pay for Medicare Part B (medical insurance) premiums.
- For some people, the Medicare Savings Programs may also pay for Medicare Part A (hospital insurance) premiums, if any, and Part A and B deductibles and co-payments.
MEDICAID AND MEDICAL assistance
- Joint Federal and state programs that help pay medical costs for some people who have limited resources and income.
- Each state has different rules about eligibility and applying for Medicaid.
- Contact your state Medicaid office for more information
Long Term MEDICAID
- A person who needs 30 or more days in continuous long-term care, may be able to receive Medicaid if income & resource limits are met.
- Medicaid may also pay for medical services that were received three months before the person applied for assistance.
MEDICAID for people with SSI
- A person who receives Supplemental Security Income (SSI) automatically receives Medicaid.
- HHSC (Health Human Services Commission) sends information about Medicaid services to people receiving Supplemental Security Income.
What's the DIFFERENCE?
Medicaid = Medical benefits and drugs
SSI = Income assistance
LIS = Part D (RX) assistance
Choose a Plan below to view more information!
MONTHLY INDIVIDUAL INCOME LIMITS
PROGRAM
QMB
$1,032
SLMB
$1,234
QI-1
$1,386
LIS
$1,507.50
MONTHLY COUPLE INCOME LIMITS
PROGRAM
QMB
$1,392
SLMB
$1,666
QI-1
$1,872
LIS
$2,030
INDIVIDUAL ASSET LIMITS
PROGRAM
QMB
$7,560
SLMB
$7,560
QI-1
$7,560
LIS
$14,100
COUPLE ASSET LIMITS
PROGRAM
QMB
$11,340
SLMB
$11,340
QI-1
$11,340
LIS
$28,150
Source: www.SSA.gov/i1020
- QMB (Qualified Medicare Beneficiary) Pays for Part A & B Premiums, Co-Ins. and Deductible.
- SLMB (Specified Low-Income Medicare Beneficiary) Pays Part B Premium.
- QI-1 (Qualifying Individual Program) First-come, first-served program. Pays Part B Premium.
- LIS (Low Income Subsidy) Extra assistance with prescription drugs.
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SOCIAL SECURITY APPLICATION