Medicare Prescription Drug Costs - An Update

Beginning in January 2006, Medicare will offer prescription drug plans to beneficiaries. But now is the time to see if you qualify for some extra financial help in paying for your monthly premiums, annual deductibles and prescription co-payments under the new program.

Social Security is working to make sure that everyone who might be eligible for this extra help applies for it. From late May through mid-August, Social Security is mailing letters to nearly 19 million people who are potentially eligible for this extra help. And we are working with federal and state agencies, advocacy groups and other interested parties in communities across the country to get the word out about the new program and the extra help that is available.

If you receive a letter in the mail, please read the information carefully. The letter will explain the prescription drug program, and tell you how to apply for the extra help. The letter includes an application and a return-addressed, postage-paid envelope. Those who qualify for the extra help could save an average of $2,100 per year.

Even if you do not get an application in the mail, you still might be eligible for help with prescription drug costs. See if you might qualify and apply online at Social Security’s website, www.socialsecurity.gov. You also can contact Social Security at 1-800-772-1213 (TTY 1-800-325-0778) for more information or to apply over the telephone.

Are You Eligible?

To qualify for the extra help, a person or married couple living together must have limited income and resources. You can qualify for this help as an individual if your total annual income is below $14,355 and your resources are valued below $10,000. The limits for a married couple living together are higher: $19,245 in combined annual income and $20,000 in resources. These resources can be slightly higher—an additional $1,500 per person—if you will be using some of your money for burial expenses. Even if your income is higher, you still may be able to get some help if, for example, you or your spouse supports other family members who live with you, if you have earnings from work or if you live in Alaska or Hawaii.

There are also certain exclusions from both income and resources. For example, your home and cars are not counted as resources. So if you think you might be eligible, you should apply.

It is important to note that some beneficiaries will automatically qualify for the extra financial help. Anyone who has both Medicare and Medicaid, or Medicare and Supplemental Security Income, or anyone whose state pays his or her Medicare premiums, will not have to complete an eligibility application. But even if you automatically qualify for extra help, you still need to enroll in a Medicare-approved prescription drug plan to obtain both coverage and the extra help.

Online Help Available

If people think they might be eligible for the extra help, one of the fastest, easiest and most convenient ways to apply is by going online. Medicare beneficiaries who want to apply for the extra financial help that is available under the new prescription drug program can do so at Social Security’s website, www.socialsecurity.gov. For anyone who qualifies, this extra help can go a long way in paying for the premiums, deductibles and co-payments related to the Medicare prescription drug program.

How To Apply Online

Just go to the Social Security’s website at www.socialsecurity.gov and click on “New Medicare Prescription Drug plan.” To get a quick idea as to whether or not you would be eligible for the extra help, choose “Qualifier Tool.” After answering a brief series of questions, you will know whether you probably do or do not qualify for the extra help with prescription drug costs.

If you do seem to qualify, simply fill out an application while online. The Application is easy-to-understand and helpful instruction sheets guide you through the Application process.

It is especially important for everyone who applies to understand that even if they qualify for the extra help, they still need to enroll in a Medicare-approved prescription drug plan to obtain both coverage and the extra help.

If you don’t have Internet access, you can call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) and representatives will be glad to assist you or send you an Application for the extra help with Medicare prescription drug costs.

To learn more about the Medicare prescription drug plans, which you can sign up for beginning November 15, call 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov.