2005-08-11 / Savvy Senior

Savvy Senior


My neighbor recently got an application in the mail from Social Security for extra help paying for her prescription drug costs. Does not getting an application mean I’m not eligible for assistance? I am 67 years old and could sure use some extra help. What can you tell me?

Looking for Extra Help

Dear Looking,

The new Medicare prescription drug benefit, which begins January 1, 2006, will offer extra help to older Americans with limited incomes, but just because you don’t get an application in the mail doesn’t necessarily mean you’re not eligible. Here’s what you should know:

Extra Help

From last May through August, the Social Se-curity Administration has been mailing out application forms to millions of Medicare beneficiaries (with limited income) who may be eligible for “extra help” paying for their out-of-pocket Medi-care prescription drug costs. More than 14 million Americans will be eligible for this extra help, which will pay between 75 and 100 percent of their drug costs.

Do You Qualify?

Nearly seven million of the Medicare beneficiaries eligible for the prescription drug extra help (the very low income) are automatically enrolled and don’t need to apply. But there’s another seven million people out there with slightly higher incomes that may also be eligible, and need to apply. Here’s how the extra help eligibility breaks down:

• Automatically Enrolled: If you are receiving Medicaid, Supplemental Security Income (SSI) or assistance with a Medicare Savings Program, you are automatically enrolled and don’t have to apply. The Centers for Medicare & Medicaid Services (CMS) should have sent a letter explaining this to you. But in late fall you will still be asked to enroll in a drug plan of your choice. If you don’t, CMS will enroll you in one.

• Must Apply: If your 2005 monthly income is below $1,197 ($1,604 for couples) and your assets are below $11,500 ($23,000 for couples), you qualify for extra help but you must apply. Even if your income or assets are above these limits, you may still qualify (and should apply) because certain types of income and assets are not included. Also, know that receiving an application in the mail from Social Security doesn’t mean you’re not eligible. If you don’t receive an application by late August and think you may be eligible, you should apply either by phone at 800-772-1213, online at www.socialsecurity.gov or you can apply in person at your local Social Security office.

Income and Assets

People who are automatically enrolled don’t have to worry about figuring their income and assets since the government has already deemed them below the limit. But for those who must apply, income means any money from work, Social Secu-rity, retirement benefits, alimony, rental property, etc. Assets that are counted include bank accounts, investments, additional real estate and the value of life insurance policies. They do not include your home, vehicles, personal possessions, burial plot and up to $1,500 intended for funeral expenses.

Savvy Tips: Remember that applying for extra help is separate from signing up for Medicare’s prescription drug coverage. To get drug coverage, you’ll still need to enroll in a Medicare drug plan between Nov. 15, 2005 and May 15, 2006. Also, if you get turned down for Medicare’s extra help, you may still qualify for assistance from your state. Some state programs have higher income limits or may not require an asset test. Your SHIP counselor can advise you. For more information on the new Medicare prescription drug plan visit www.medi-care.gov.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior.org.

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