Medicare Subsidies and Aid programs

When it comes to Medicare there are two main forms of aid—Medicaid and Low Income Subsidy (LIS). Both programs are income-based programs run by the state but each assists a Medicare Beneficiary in different ways. Medicaid helps an individual with Medical costs (doctors, hospitals, outpatient procedures, etc.) whereas Low Income Subsidy (also called, “Extra Help”) is specifically designed to help an individual with prescription drug copays and coinsurance on his/her Part D plan.

Some folks that I have come into contact with become disheartened when they learn they aren’t eligible for Medicaid. However, that doesn’t mean that they aren’t eligible for any aid at all. An individual can make more money and be eligible for Low Income Subsidy (“Extra Help”) even though he/she makes too much money to be Medicaid-eligible. Securing this type of aid can make the difference between paying under $10 for a prescription versus paying hundreds of dollars for that same prescription. It is vital to know if you are eligible for this program by applying through Social Security.

According to Social Security’s website (www.ssa.gov), as of May 1 of 2016, Low Income Subsidy eligibility is described as—

  1. “Your resources must be limited to $13,640 for an individual or $27,250 for a married couple living together. Resources include such things as bank accounts, stocks and bonds. We do not count your home, car, or any life insurance policy as resources; and
  2. “Your annual income must be limited to $17,820 for an individual or $24,030 for a married couple living together. Even if your annual income is higher, you still may be able to get some help. Some examples where you may have higher income and still qualify 3 for Extra Help include if you or your spouse: —Support other family members who live with you; —Have earnings from work; or —Live in Alaska or Hawaii.”

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