Want to save money on Medicare costs?
Two programs are available to help people with Medicare stretch their healthcare dollars. Please see below for further information.
Extra Help
“Extra Help” is a federal program that helps with Medicare Part D (prescription drug) costs. This Limited Income Subsidy:
- Reduces your plan’s monthly premium, often to $0
- Cuts the yearly deductible, often to $0
- Greatly reduces pharmacy copays, even on expensive medications
- Allows you to change Medicare plans 1x per quarter, January 1 – September 30.
Medicare Savings Programs
Medicare Savings Programs are state programs that:
- Help pay some Medicare Part A and Part B costs AND
- Automatically include the package of Part D “Extra Help” prescription drug benefits (except with QDWI)
- The amount of assistance you qualify for depends on your income and assets
2022 Income and Asset Limits (Updated May 2022)
| Extra Help Program | Family Size | Monthly Income | Assets* | Your Subsidized Drug Plan Benefit |
|---|---|---|---|---|
| Extra Help Full Subsidy | Individual | $ 1,549 | $ 8,400 | Low or $0 premium;$0 deductible $3.95-9.85 copay. |
| Married Couple | $ 2,080 | $12,600 | ||
| Extra Help Partial Subsidy | Individual | $ 1,719 | $14,010 | 25-75% premium reduction; $99 annual deductible; 15% copay |
| Married Couple | $ 2,309 | $27,950 |
* Assets (resources) include money in bank accounts, stocks, bonds and real estate. Your home, one car, personal possessions, burial plot and $1,500 per person in an account designated for burial expenses are not counted.
| Medicare Savings Program | Family Size** | Monthly Income | Assets* | Helps you with |
|---|---|---|---|---|
| Qualified Medicare Beneficiary (QMB) | Individual | $ 1,153 | $ 8,400 | Part A & Part B premiums, deductibles and copays. Extra Help Full Subsidy |
| Married Couple | $ 1,546 | $12,600 | ||
| Specified Low Income Medicare Beneficiary (SLMB) | Individual | $ 1,379 | $ 8,400 | Part B premium Extra Help Full Subsidy |
| Married Couple | $ 1,851 | $12,600 | ||
| Qualifying Individual (QI) | Individual | $ 1,549 | $ 8,400 | Part B premiums Extra Help Full Subsidy |
| Married Couple | $ 2,080 | $12,600 |
** Married couples can choose to have their income counted under the Community Property Method. With this method one spouse might qualify as an individual for a Medicare Savings Program.
Medicare eligible individuals under 65 with a higher monthly income who are working may qualify for the WWD and/or QDWI Programs.
Other programs are available for Home Based Community Services and Nursing Home Assistance. (Speak to your local Health & Welfare Office about eligibility requirements.)
These limits are guidelines. The only way to know for sure if you qualify is to apply.
Extra Help
“Extra Help” is managed by the federal Social Security Administration.
It’s Easy to Apply!
Apply online at socialsecurity.gov
Visit a local Social Security office or call Social Security at 1-800-772-1213
Call SHIBA at 1-800-247-4422
When you file an application for Extra Help, you also initiate an application for a Medicare Savings Program. Idaho Medicaid will contact you to finish the application.
Medicare Savings Programs
Medicare Savings Programs are administered by the State of Idaho.
To Apply:
Call Health and Welfare at 1-877-456-1233 for a mail-in application;
Visit a Health and Welfare office; or call 1-877-456-1233 for assistance
You may be asked to provide an ID and information verifying your income and assets when applying for this benefit.
Using Extra Help Drug Coverage
You must have a Part D plan in order to use Extra Help. If you are not yet enrolled in a Medicare Prescription Drug Plan or a Medicare Advantage plan, you can still use Extra Help right away. Humana LI-NET will be your temporary plan until a Medicare plan starts. Have your pharmacy call 1-800-783-1307 for coverage information.
- Extra Help (LIS) does NOT use Estate Recovery
- Medicare Savings Programs (MSP) do NOT recover costs from your estate
- Full Medicaid does use Estate Recovery
- For more information call the Idaho Medicaid Estate Recovery Office at 1-866-849-3843