| Thu, Aug 02, 2012 @ 09:00 AM

How to Get Help with the Cost of Medicare

Posted by Medicare Made Clear

Get help with cost of medicareIf you’re having trouble with Medicare costs, there’s help. A number of state and federal programs help people with limited incomes, resources or assets pay for health care.

Many people on Medicare who could get financial help don’t apply. There’s no penalty or fee to apply, even if you don’t qualify for assistance. So if you need help paying your medical or prescription drug expenses, take a moment to look over these programs.

Medicaid (or Medical Assistance) is a joint federal and state program that helps pay medical costs for certain people and families with limited income and resources. Medicaid provides some benefits that Medicare may not cover. These may include prescription drugs, eye care and long-term care.

Medicare Savings Programs (MSPs) are programs that pay Medicare premiums for people who qualify. They may also pay deductibles and coinsurance for Original Medicare Parts A and B. There are three types of MSPs, which serve different groups of people and cover different costs.

The Program for All-Inclusive Care for the Elderly (PACE) helps people who qualify for nursing home care stay in their homes. PACE provides long-term services to people on Medicare and Medicaid. You must be 55 or older and able to live safely in the community with help. You also need to live in the service area of a PACE organization.

In order to learn more about Medicaid, MSPs or PACE, or to apply, contact your state Medicaid office. You can find that contact information on the Medicare Helpful Contacts page at Medicare.gov. You can also call the Medicare helpline: 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24 hours a day, 7 days a week.

Pharmaceutical Assistance Programs (PAPs) are operated by pharmaceutical companies. They help people on Medicare Part D plans by paying for some or all of the drugs that the pharmaceutical company manufactures. Some states have State Pharmaceutical Assistance Programs (SPAPs) that help Medicare Part D members by paying for their monthly drug plan premium.

For more information on PAPs and SPAPs, go to Medicare.gov. The State Index page for SPAPs can give you information on your state’s SPAPs, if you have them. You can also go to the Medicare.gov PAP page and search on the name of your drug to see whether the pharmaceutical company offers help through a PAP.

Extra Help (or Low-Income Subsidy, or LIS) is a program that helps pay the costs of Medicare Part D prescription drug coverage. You automatically qualify for Extra Help if you get any one of these:

  • Full coverage from a state Medicaid program.
  • Help from your state Medicaid program paying your Medicare Part B premiums.
  • Supplemental Security Income (SSI) benefits.

 

In 2012, covered drug costs for most people who qualify for Extra Help are $2.60 for generics or $6.50 for brand-names. Some people may qualify to pay only a portion of their Medicare Part D drug plan premium and deductible.

You can apply for Extra Help https://secure.ssa.gov/i1020/start, SSA.gov. Or you can call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) to apply by phone or get a paper application. Hours of service are Monday – Friday, 7 a.m. – 7 p.m.

For more information, contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. If you have questions about Medicare Made Clear, call 1-877-619-5582, TTY 711, 8 a.m. – 8 p.m. local time, seven days a week.

Resources:

Financial Help with Medicare – MedicareMadeClear.com

Talking About Medicare: Medicare and People with Low Incomes – Kaiser Family Foundation

Caregivers: Is Additional Financial Support Available? – Medicare.gov

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