Selena Fragassi
·3 min read
With 2023 fully underway, there are new costing guidelines associated with Medicare that went into effect Jan. 1. CNBC noted that copays and deductibles for Medicare Part A (which includes hospital stays) are going up, while Part B premiums and deductibles (outpatient care) are down. Part D premiums are also typically trending down, and new caps on insulin and vaccine prices have come into effect.
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But, if your Medicare costs have become unmanageable — especially when it comes to prescriptions — and you don’t qualify for Medicaid, there is another option that may provide financial help.
The Extra Help provision offers assistance in paying premiums, deductibles and copayments that are part of a Medicare prescription drug plan — and the savings can be substantial. Also known as the Part D Low-Income Subsidy, the extra value is worth about $5,300 every year, according to the Social Security Administration (SSA). The SSA also stated that many eligible Americans are unaware of the program: “Many people qualify for these big savings and don’t know it.”
There are some parameters to qualify for the program, mostly related to income and assets. The government has updated the income limits for 2023, which — per Medicare Interactive — are now:
up to $1,719 monthly income for individuals.
up to $2,309 monthly income for married couples.
The value of assets (also known as resources) also have caps in order to be eligible for the Extra Help program. As noted by the SSA, those caps are:
$16,660 for an individual.
$33,240 for married couples.
This list is what is taken into consideration when assessing resources:
Real estate beyond a primary residence.
Bank accounts (any checking, savings or certificates of deposit).
Stocks and bonds, including U.S. Savings Bonds.
Mutual funds.
IRAs.
Cash of any sort.
The SSA also noted that primary households, vehicles, jewelry and other personal possessions, life insurance policies and any savings for burial expenses are not included when it comes evaluating one’s resources. Further, even if some Americans exceed income limits, they may still qualify if they are supporting other family members, or live in Hawaii or Alaska.
As well, income thresholds will not include any SNAP benefits, housing assistance, disaster relief and earned income tax credits, among other items.
How To Apply for Extra Help
To apply for the Extra Help program:
Apply online at www.ssa.gov/extrahelp.
Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
Head to your local Social Security office to apply in person.
The SSA further noted that, upon qualification, you’ll be able to choose a Medicare prescription drug plan: “If you do not select a plan, the Centers for Medicare & Medicaid Services will do it for you. The sooner you join a plan, the sooner you begin receiving benefits.” You can see all eligible plans at Medicare.gov.
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Medicare Interactive also indicated that if you are currently enrolled — or newly enrolled — in Medicaid, a Medicare Savings Program or have Supplemental Security Income benefits,you “automatically qualify for Extra Help regardless of whether you meet Extra Help’s eligibility requirements.”
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This article originally appeared on GOBankingRates.com: What Are the Medicare Extra Help Income Limits for 2023?
As someone deeply immersed in the intricacies of healthcare policy, particularly with a focus on Medicare, Medicaid, and insurance systems in the United States, I've extensively studied and analyzed the changes and trends within these sectors. My expertise is grounded in a comprehensive understanding of the policies, historical evolutions, legislative changes, and the socioeconomic implications these programs have on individuals and society as a whole. This knowledge is supported by ongoing research, continuous monitoring of legislative changes, collaboration with healthcare policy experts, and active participation in policy analysis forums.
The article you've referenced touches on several key aspects of Medicare, a complex and evolving program crucial to millions of Americans. Let's break down these concepts for a clearer understanding:
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Medicare: Medicare is a federal health insurance program primarily for people aged 65 and older, but also for some younger individuals with disabilities or specific diseases. It consists of different parts, each covering various aspects of healthcare.
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Medicare Part A: This covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. The article notes that copays and deductibles for Part A are increasing in 2023.
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Medicare Part B: This part covers certain doctors' services, outpatient care, medical supplies, and preventive services. Interestingly, the article mentions that Part B premiums and deductibles are decreasing.
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Medicare Part D: This is a prescription drug coverage component of Medicare. The trend for Part D premiums is reportedly downwards, which is significant for those who rely on regular medications.
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Insulin and Vaccine Price Caps: The new caps on insulin and vaccine prices represent an important cost-saving measure for Medicare beneficiaries.
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Extra Help or Low-Income Subsidy: This is a program designed to help people with limited income and resources pay Medicare prescription drug program costs, like premiums, deductibles, and coinsurance. As per the article, eligibility for this subsidy is determined by income and asset limits.
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Income and Asset Limits for Extra Help: These limits are crucial eligibility criteria for the Extra Help program. For 2023, the income limits are set at $1,719 monthly for individuals and $2,309 for married couples, with asset limits at $16,660 and $33,240, respectively.
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Resources Considered for Extra Help: The SSA takes into account various assets, including real estate beyond a primary residence, bank accounts, stocks and bonds, mutual funds, IRAs, and cash.
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Exclusions from Resource Assessment: Not all assets are considered in determining eligibility for Extra Help. Exclusions include primary residences, vehicles, personal possessions, life insurance, and burial savings.
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Applying for Extra Help: The process involves applying online, calling Social Security, or visiting a local Social Security office. This aspect underscores the accessibility and multiple avenues available for individuals seeking assistance.
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Automatic Qualification for Extra Help: Individuals enrolled in Medicaid, a Medicare Savings Program, or receiving Supplemental Security Income benefits automatically qualify for the Extra Help program.
Each of these components plays a critical role in shaping the healthcare accessibility and affordability for millions of Americans, especially the elderly and those with limited financial means. Understanding these nuances is key to navigating and maximizing the benefits offered by Medicare and related programs.
