People With Medicare

Do I qualify for extra help with costs?

There are different levels of extra help available, depending on your income and assets. People with a lower income and fewer assets get more help with their Medicare drug plan costs.

Level 1  You may qualify for extra help if
your yearly income is less than this amount-- AND the amount of resources you own does not exceed
$10,400 for an individual or $14,000 for a couple $8,100 for an individual or $12,910 for a couple
Level 2  You may qualify for extra help if
your yearly income is less than this amount-- AND the amount of resources you own does not exceed
$14,040 for an individual or $18,900 for a couple $8,100 for an individual or $12,910 for a couple
Level 3  You may qualify for extra help if
your yearly income is less than this amount-- AND the amount of resources you own does not exceed
$15,600 for an individual or $21,000 for a couple $12,510 for an individual or $25,010 for a couple

The resource amount includes $1,500 in savings that you can use as a burial fund. Couples can have $3,000 for the burial savings.

You may not qualify for extra help with costs if your income or assets are over these limits.

What if I don't qualify for the extra help?

There are special circumstances that let you have a higher income or more resources and still qualify. For example, if you work, if you support other family members who live with you, or if you live in Hawaii or Alaska, you may qualify even if your income is higher than these limits. There are also other programs that might be able to help you with your medical costs. The "BenefitsCheckUp" questionnaire can help you find out if you are likely to qualify for extra help or for help from other programs.

How much will I pay in 2009 if I get the extra help?

Level 1
Premium: None
Deductible: None
For drugs, you would pay: $1.10 co-pay for generic drugs on your plan's drug list
$3.20 co-pay for brand name drugs on your plan's drug list
  If your total drug costs go over $6,153.75 for the year, you pay no co-pay for drugs on your plan's drug list
Level 2
Premium: None
Deductible: None
For drugs, you would pay: $2.40 co-pay for generic drugs on your plan's drug list
$6.00 co-pay for brand name drugs on your plan’s drug list
  If your total drug costs go over
$6,153.75 for the year, you pay no co-pay for drugs on your plan’s drug list
Level 3
Premium: Sliding Scale
Deductible: $60
For drugs, you would pay: 15% up to $6,153.75
  If your total drug costs go over $6,153.75 for the year, you pay:
$2.40 co-pay generic drugs on your plan’s drug list
$6.00 co-pay for brand name drugs on your plan’s drug list

Remember that everyone with Medicare qualifies for the Medicare Prescription Drug Coverage. If you qualify for extra help or not, you need to join a Medicare drug plan to get Medicare Prescription Drug Coverage.

NEXT: What information do I need to apply for extra help?