Extra Help Copays 2020

Extra Help Copays 2020 Application
Full Extra Help Copays 2020
What Is Medicare Copay For 2020

The Federal Government provides an extensive program for people needing financial assistance with the Medicare Part D program. Depending on your income and available financial resources , Medicare will provide 'Extra Help' that may cover 85% to 100% of prescription costs and may also pay a part or all of your Medicare Part D premiums.

Who Qualifies for 'Extra Help'?

For the plan year 2021 If your income is below $19,320 per year for a single person (or $26,130 for a married couple living together or even more if you have dependent children or grandchildren living with you), AND if your assets (resources) are below $13,290* for a single person (or $26,520* if you are married). *These limits do not include the $1,500 per person burial exclusion, see more details below.

Full Extra Help $0 premium and deductible3 $3.70 generic copay $9.20 brand-name copay No copay after $6,550 in out-of-pocket drug costs Medicaid and/or a Medicare Savings Program Up to $1,093 ($1,472 for couples) per month1 Full Extra Help $0 premium and deductible3 $1.30 generic copay $4.00 brand-name copay. 2021 Extra Help/LIS copay levels & costs. People on these programs are “deemed” eligible for LIS – they don’t need to apply! Beneficiary group Monthly income. Monthly premium. Annual deductible. Total covered spending: ≤$9,314 $9, 314 Income and assets vary by program rules Full Medicaid (Categorically.

The Healthcare Reform provides that for plan year 2020, all formulary drugs will have at least a 75% discount in the coverage gap (Donut Hole). The Gap Coverage Types discussed in this section are supplemental coverage your plan pays in addition to the Healthcare Reform mandated discounts. In our chart, you will see one of the following. S had full Extra Help and a monthly income below $1,094, his copays would be $1.30 for generics and $4.00 for brand-name drugs, making his generic Extra Help copay less costly than the plan copay of $1.35. This means that Mr. S would pay the Extra Help copay throughout the year.

The following items are NOT included in income:

Housing assistance,
Medical treatment and drugs,
Food stamp assistance, etc.

Click Here to see more payments that do NOT count toward income.

$1,500 per person Burial Exclusion:
All beneficiaries are permitted a $1,500 per person burial exclusion from their resources. This exclusion can be taken into account by either reducing your resources by $1,500 per person (Medicare & Your Handbook) or by increasing the resource limit by $1,500 per person (Most other Social Security Administration and Medicare documents). Below is a chart showing the resource figures with, and without taking into account the burial exclusion:

Maximum Resource Limit	With $1,500 Burial Exclusion	Without $1,500 Burial Exclusion
Individuals	$14,790	$13,290
Couples	$29,520	$26,520

The following items are included in resources:

bank accounts,
stocks and bonds,
Real estate (other than your primary residence), etc.

The following items are NOT included in resources:

the house you live in,
your car,
other personal possessions such as your furniture and jewelry, etc.
burial plots,
up to$1,500 for burial expenses (per person), or
life insurance policies.

Click Here to see more assets that do NOT count toward resources.

Click on the year below to change the above qualification figures to the selected year:
202020192018201720162015201420132012201120102009200820072006
If you receive the full Extra-Help, full LIS, or are dual eligible for Medicare and Medicaid, there are Medicare Prescription Drug plans in your state the will qualify for the $0 monthly premium. Click on your state below to see PDP plans that qualify for the $0 premium:
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Who Should You Contact for 'Extra Help'?

Medicare Beneficiaries Who are interested in qualifying for financial 'extra help' with the Medicare Part D Prescription Drug plans should visit http://www.socialsecurity.gov/i1020

Also see:

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Medicare provides 'Extra Help' to pay prescription drug costs for people who have limited income and resources. Resources include your savings and stocks, but not your home or car. If you qualify, you will get help paying for your Medicare prescription drug plan's monthly premium, yearly deductible, prescription co-payments and coinsurance. This Extra Help also counts toward your out-of-pocket costs.

Some people automatically qualify for Extra Help and don't need to apply. Medicare mails a letter to people who automatically qualify for Extra Help.

To see if you qualify for getting Extra Help call:

1-800-MEDICARE (1-800-633-4227). TTY users call 1-877-486-2048. Get information 24 hours a day, 7 days a week. You can also visit www.medicare.gov(By clicking on this link you will be leaving the Allwell from Arizona Complete Health website.) to view a copy of the 'Medicare and You' handbook- see section 'Programs for People with Limited Income and Resources'; or
The Social Security Administration at 1-800-772-1213 between 7:00 a.m. and 7:00 p.m., Monday through Friday. TTY users call 1-800-325-0778; or
Your State Medicaid Office

After you apply, you will get a letter letting you know if you qualify for Extra Help and what you need to do next.

Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

For HMO Members

Plans	CMS#	County	Low Income Subsidy
Allwell Medicare (HMO)	H0351 - 044-001	Pima	Low Income Subsidy, H0351 - 044-001 - English (PDF)
Allwell Medicare (HMO)	H0351 - 044-002	Cochise and Santa Cruz	Low Income Subsidy, H0351 - 044-002 - English (PDF)
Allwell Medicare Premier (HMO)	H9287 - 001	Pima	Low Income Subsidy, H9287 - 001 - English (PDF)
Allwell Medicare Essentials II (HMO)	H0351 - 050	Maricopa, Pinal	Low Income Subsidy, H0351 - 050 - English (PDF)
Allwell Medicare Premier (HMO)	H0351 - 051	Maricopa, Pinal	Low Income Subsidy, H0351 - 051 - English (PDF)
Allwell Medicare (HMO)	H5590 - 004	Yavapai and Yuma	Low Income Subsidy, H5590 - 004 - English (PDF)
Allwell Medicare Essentials (HMO)	H5590 - 005	Maricopa and Pinal	Low Income Subsidy, H5590 - 005 - English (PDF) Low Income Subsidy, H5590 - 005 - Spanish (PDF)
Allwell Medicare Essentials I (HMO)	H5590 - 007	Cochise, Maricopa, Pima, Pinal, Santa Cruz, Yuma	Low Income Subsidy, H5590 - 007 - English (PDF)

For HMO D-SNP Members

Plans	CMS#	County	Low Income Subsidy
Allwell Dual Medicare (HMO C-SNP)	H5590 - 008	Cochise, Gila, Graham, Greenlee, La Paz, Pinal, Santa Cruz	Low Income Subsidy, H5590 - 008 - English (PDF)
Allwell CHF/Diabetes (HMO D-SNP)	H0351 - 038	Maricopa, Pinal	Low Income Subsidy, H0351 - 038 - English (PDF)

See if You Qualify for Extra Help

Some people automatically qualify for the Extra Help program and don't need to apply. Medicare will mail you a letter if you automatically qualify for Extra Help.
Your income and resources can change from year to year, so check to see if you qualify for the program if you didn’t receive a letter from Medicare or were previously denied for the Extra Help program.

Apply for Extra Help

Applying for Extra Help is easy. Just complete the Social Security’s application for the Medicare Extra Help program in the following ways.

By Phone

Call 1-800-772-1213 between 7:00 a.m. and 7:00 p.m., Monday through Friday. TTY users call 1-800-325-0778.

Apply Online

Complete an online application. (By clicking on this link you will be leaving the Allwell from Arizona Complete Health website.)