Extra Help
A federal subsidy that pays most of the cost of Medicare prescription drug coverage.
What it means
Extra Help — formally the Low-Income Subsidy — pays the premium, reduces or removes the deductible, and caps the copayment for Medicare Part D. For somebody who qualifies fully it turns prescription costs from a serious monthly expense into a nominal one.
It is administered by the Social Security Administration rather than by Medicare, and it is applied for separately. People receiving Medicaid, Supplemental Security Income, or a Medicare Savings Program are enrolled automatically; everybody else has to ask.
The income and asset limits are considerably more generous than the word “Help” implies, and a substantial number of people who would qualify have never applied. Applying costs nothing and can be done at any time of year.
It also removes the late enrollment penalty for anyone who qualifies, which matters for somebody who went without drug coverage for a period and has been paying a permanently increased premium since.
Why it matters
Prescription costs are the expense that most often causes an older person to ration medication, and this is the program that removes it.
It does not start itself, and the people most likely to qualify are the least likely to be told about it.
When you are likely to meet it
- When a parent is choosing or reviewing a Part D plan.
- When somebody is skipping doses because of cost.
- When a Medicare Savings Program application is being made — the two are usually applied for together.