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Who Is Eligible for Extra Help to Pay for Medicare Prescription Drug Plan Costs?

Article Courtesy of the Social Security Administration

Did you know that in January 2006 a new program will provide the first prescription drug coverage ever offered under Medicare? And did you also know that, if you are a Medicare beneficiary with limited income and limited resources, you may be able to get extra help paying for prescription drug costs?

Here's a quick primer of basic information about the new Medicare prescription drug program and the extra help that could be available to you.

What will the new Medicare prescription drug program provide?

The new Medicare prescription drug plans will help beneficiaries pay for their prescription medicines. The savings will vary, depending upon which plan a beneficiary chooses. In general, for 2006, beneficiaries will pay a monthly premium of about $37 and a yearly deductible of $250. The Medicare plan will help pay for prescription drug purchases (up to a limit of $2,250). But if a beneficiary's total out-of-pocket expenses for drugs reaches $3,600, then Medicare pays 95 percent of the costs for the rest of the year.

What will the extra help pay for?

For those who qualify, the extra help will reduce or eliminate the monthly premiums, annual deductibles and prescription co-payments under the new prescription drug program. The extra help can save qualified beneficiaries an average of $2,100 per year.

Who is eligible for the extra help?

People should apply for the extra help if they meet both of the following income and resource limits:

-- Have an annual income of $14,355 or less for an individual; or have $19,245 or less as a married couple living together. Annual income can be higher if they support other family members who live with them; have earnings from work; or live in Alaska or Hawaii; and

-- Have resources worth $10,000 or less for an individual, or $20,000 or less for a married couple living together. These resource limits can be slightly higher (an additional $1,500 per person) if some of the money will be used for burial expenses. Resources include bank accounts, stocks, bonds, and other things that they own. The value of an applicant's primary residence and any automobiles are not included.

(Some beneficiaries will automatically qualify for the extra financial help. Anyone who has both Medicare and Medicaid, or Medicare and Supplemental Security Income, or anyone whose state pays his or her Medicare premiums, will not have to complete an eligibility application.)

How can I apply for the extra help?

Just complete an application and return it to Social Security. If you did not receive an application for the extra help in the mail, but think you may be eligible, you can complete an application for the extra help online at www.socialsecurity.gov.