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Tuesday, February 19 , 2019, 3:54 pm | Fair 55º


Capps Urges Low-Income Seniors to Apply for ‘Extra Help’ with Prescriptions

Recent changes to the program make eligibility requirements more flexible

Rep. Lois Capps, D-Santa Barbara, this week alerted low-income Medicare beneficiaries and their family members on the Central Coast to changes in the “Extra Help” program to help cover the cost of prescriptions.

Extra Help is available to low-income Medicare beneficiaries who have limited resources and income to help cover the cost of their prescription drugs. The beneficiary will receive co-pay assistance for prescription drugs, bringing costs to no more than $2.50 for each generic drug and $6.30 for each brand-name drug.

“I am strongly encouraging all low-income Medicare beneficiaries to look into whether they are eligible for Extra Help, even if they were ineligible in the past,” Capps said. “No senior should be forced to choose between buying food or paying for their prescriptions. And too many seniors are unaware that extra assistance is there for them, so they are not faced with that choice.”

“The eligibility requirements are more flexible than they were a couple of years ago. Extra Help can be lifesaving for someone who needs prescription drugs and needs help with the cost,” said Dr. Don Berwick, administrator of the Centers for Medicare & Medicaid Services. “If you were turned down for Extra Help in the past due to income or resource levels, you should reapply. If you qualify, you will receive help paying for Medicare prescription drug coverage premiums, co-payments and deductibles.”

It is estimated that 2 million Americans qualify for the program but are not yet enrolled. To qualify, Medicare beneficiaries’ incomes must be less than $16,335 a year (or $22,065 for married couples) and have resources limited to $12,640 (or $25,260 for married couples). Resources include bank accounts, stocks and bonds, but do not include a beneficiary’s house, car or life insurance policy. The qualifications have changed recently, so those who did not qualify in the past may now the eligible.

Changes resulting from the Medicare Improvements for Patients and Providers Act of 2008 made it easier for Medicare beneficiaries to qualify for Extra Help by changing the way income and assets are counted. As of last year, the Social Security Administration, which determines eligibility for the program, does not count life insurance policies as a resource for eligibility purposes. In addition, help received from family and friends to pay for household expenses like food, mortgage, rent and utilities does not count as income.

There is no cost to apply for Extra Help. Medicare beneficiaries, family members, trusted counselors or caregivers can apply online in English and Spanish. Click here to get started. Beneficiaries may also call the Social Security Administration at 800.772.1213 (TTY users should call 800.325.0778) and ask for the application for Medicare’s Part D, Extra Help. All information provided is confidential.

— Ashley Schapitl is press secretary for Rep. Lois Capps, D-Santa Barbara.

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