Extra Help with Medicare Prescription Drug Costs
The Federal government has a program called Extra Help (also called the Low Income Subsidy). This program helps
people with limited incomes pay for their prescription drug costs with Medicare Part D. Read more about
Extra Help and how you may qualify for it.
People with limited incomes may qualify for to pay for their
prescription drug costs. If you qualify, Medicare could pay for up to seventy-five (75) percent or more of your drug
costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who
qualify will not be subject to the Coverage Gap or a Late Enrollment Penalty. Many people are eligible for these
savings and don’t even know it. For more information about this Extra Help, contact your local Social Security
office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call
1-877-486-2048.
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for
extra help, call:
- 1‐800‐MEDICARE (1‐800‐633‐4227). TTY users should call 1‐877‐486‐2048, 24 hours a day/7 days a week;
- The Social Security Office at 1‐800‐772‐1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1‐800‐325‐0778; or
- Your State Medicaid Office.
If you qualify for Extra Help, once you are enrolled in one of our Medicare Advantage Prescription Drug (MA-PD)
plans, this subsidy will be applied to your coverage, and we will send you information on the lower amount for
your monthly premium. At the pharmacy, you will be charged lower copayments for your prescription drugs. Note
that Extra Help will not pay for your monthly Medicare Part B premium.
Your monthly plan premium will generally be lower once you receive Extra Help from Medicare. There are four different levels of Extra
Help. Depending on which level you are eligible for, your monthly plan premium will vary. The four levels of
Extra Help cover either, 100%, 75%, 50% or 25% of your monthly Medicare Part D plan premium.
Extra Help does not always apply to the full amount of your Medicare Part D plan premium.
Remember: In order to use the Extra Help Program you must be enrolled in a Medicare Prescription Drug Plan (PDP)
or MA-PD plan.
Extra Help will work with all of Universal American's MA-PD plans. Find out more about getting Extra Help to pay for your prescription drug costs with TexanPlus HMO plans.
TexanPlus HMO LIS Premiums
This chart (PDF)
shows what you might expect to pay for your medications if you qualify for 100%, 75%, 50% or 25% Extra Help as a TexanPlus HMO member.
Note: the premiums listed in the chart are for both medical services and prescription drug benefits.
Extra Help:
The program run by the Social Security Administration that helps with the costs of Medicare Prescription Drug Coverage (Part D) . If you qualify, Social Security will enroll you in the program. The amount of assistance you receive will depend on your financial situation and income.