865-203-2040 karen@sisgrouptn.com

Medicare Additional Benefits

Did you know that qualifying individuals may be eligible for extra benefits and additional enrollment periods throughout the year? Depending on your income and assets Medicare offers assistance with your prescription drug premium costs, as well as the actual prescription drug costs.  You may also qualify for extra help paying for your Part B premium.

Extra Benefits Help

If you qualify for this program referred to as “Extra Help with Prescription Drugs”, Social Security will pay part of or all of your prescription drug premium.

  • Your prescriptions in 2023 will be no more than $4.15 for each generic and $10.35 for each brand-name-covered drug.
  • It is a simple application found on Social Security’s website.
  • The application takes less than ten minutes to complete and you can get an answer via mail from Social Security within two to three weeks.
  • The current monthly income limit to qualify is $1843 per month if you are single or $2485 if you are married.
  • This is current as of January 2023 and these numbers can change occasionally.
  • The asset limits are $15,160 for a single person and $30,240 for a married couple.  The government does not count your home, vehicles, personal possessions, life or burial insurance, or back payments for Social Security or SSI towards your assets.

The application can be found at:  https://www.ssa.gov/benefits/medicare/prescriptionhelp/  or if you contact us, we would be happy to assist you in completing the application.  If you have LIS or Extra help you are eligible to change Medicare Advantage plans once per quarter for the first three quarters of the year, then one more time during open enrollment between October 15 – December 7.

Extra Help for Part B

To get extra help paying for the Part B premium, you need to apply with your state Medicaid office.  This is part of the Medicare Savings Program. This program is called SLMB or QI.  Again, this extra benefits program is income and asset-based and the rules can vary slightly between states.

  • For most states to qualify for QI which helps pay all or part of your Part B premium, your income must be under $1660 per month for singles and under $2239 per month for married couples.
  • Your asset levels must be below $9090 for singles and $13,630 for married couples.
  • SLMB is also part of the Medicare Savings Program and it pays all of your Part B premium.
  • Your income needs to be under $1478 for singles and under $1992 per month for married couples, with the assets being under $9090 for singles and under $13,630 for married couples.

These applications can be obtained from your state’s Medicaid office.  Again, if you have been approved for this program you are eligible to change your Medicare Advantage plans once per quarter for the first three quarters of the year and again once during open enrollment which is October 15 – December 7.

Hopefully, this helps you understand more about the programs that may be available to you as a Medicare Beneficiary.  Check us out at www.bigorangemedicare.com or https://www.medicareinsurancespecialty.com/contact-us/.  Or call us at 865-228-8627 or 865-203-2040 with questions.

*Medicare Insurance Specialty Group is Not Approved By, Endorsed By, or Affiliated With A Government Agency. We do not offer every plan available in your area.  Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

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