Extra Help (LIS)
& Medicaid

Do you qualify for Extra Help on your medications?  Are you still paying your Part B premium out of your SSI check?  Many Seniors qualify for help.  See if you qualify.

If you qualify for Extra Help and or the Medicare Savings Program with Medicaid, you could qualify for many extra benefits from your Medicare Advantage plan.

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Call your agent to see what benefits you can qualify for because of your status.

Do you Qualify?

Get Extra Help to pay your Medicare drug costs

If you have limited income and resources, you may qualify for help to pay for some health care and drug coverage costs.

 

Extra Help is a program to help people with limited

income and resources pay Medicare drug costs. You may qualify for Extra Help if your yearly income and resources are:

 

For 2024, an enrollee's monthly income must be below $1,903 for an individual ($2,575 for a couple). Resources—which include stocks, bonds, and money in a checking, savings, or retirement account—must be below $17,220 ($34,360 for a couple).

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What you'll pay under Extra Help in 2024

Plan premium: $0.

Plan deductible: $0.

Prescriptions: Up to $4.50 for each generic drug. Up to $11.20 for each brand-name drug. Once your total drug costs (what both you and your plan pay) reach $8,000, you'll pay $0 for each covered drug.

 

If you qualify for Extra Help and join a separate Medicare drug plan or Medicare Advantage Plan with Medicare drug coverage (Part D):

You’ll get help paying your drug coverage costs.

You won’t pay a late enrollment penalty.

Online Application – takes 5 minutes

htps://www.ssa.gov/benefits/medicare/prescriptionhelp.html

Medicare Savings Programs in Alabama - 2024

The QMB Program

•  Pays the Medicare Part B premium, which is $174.70 per month;

•  Covers the Medicare deductible, which is $1,632 for the hospital and $240 for doctor and medical visits, when you use a provider who accepts Medicaid;

•  Pays the Medicare Part A premium when certain conditions are met. (If you do not have free Part A, you must apply for Conditional Part A at the local Social Security Office between the months of January and March or the month before, after, or on your 65th birthday. QMB coverage starts the month after you have been approved by Medicaid.

QMB Income limits:

•  $1,275.00 per month (gross) for individuals who are single, widowed, divorced, or separated, or

•  $1,724.00 per month (gross) for a couple.

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Specified Low Income Medicare Beneficiary (SLMB) Program

Under the Specified Low Income Medicare Beneficiary (SLMB) program, Medicaid pays the Medicare Part B premium only, which is $174.70 per month.

You will not receive a Medicaid card for the SLMB Program. Coverage may begin up to three months prior to the application month if you meet the requirements.

SLMB Income limits:

•  $1,275.01–$1,526.00 per month (gross) for individuals who are single, widowed, divorced, or separated,

•  $1,724.01–$2,064.00 per month (gross) for a couple.

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Qualified Individual-1 (QI-1) Program

Under the Qualifying Individual-1 (QI-1) program, Medicaid pays the Medicare Part B premium only, which is $174.70 per month.

You will not receive a Medicaid card for the QI-1 Program. Coverage may begin up to three months prior to the application month if you meet the requirements.

•  $1,526.01–$1,715.00 per month (gross) for individuals who are single, widowed, divorced, or   separated,

•  $2,064.01–$2,320.00 per month (gross) for a couple.

1.How do I apply for the Medicare Savings Programs?
Complete a Form 211 and mail to the District Office that serves the county where you live. A listing of the District Offices is on the last page of the application.

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2.What happens to the application once it reaches the District Office?   
MEDICARE SAVINGS PROGRAM

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Your application will be assigned to a caseworker who will review the information provided. You will be contacted by mail or phone if they have any questions.

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Please follow the instructions listed on page 1 of the application to avoid delays in processing your application. You will be notified by mail of the status (approval or denial) of your application

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3.How long does it take Social Security to stop taking the Part B premium out of my check?
It will take two months for Social Security to stop taking the Part B premium out of your check. Once the premium is stopped, you will get a refund of all the premiums taken out of your check for the months you were deemed eligible for a Medicare Savings Program. If your check is direct deposit, your refund will also be direct deposit. If after 2 months from the month you were awarded for a Medicare Savings Program, Social Security continues to take out the Part B premium from your check, please contact the Medicaid Agency’s Buy- In Unit at (334) 242-5268.

Click Below: