Help with Prescription Drug Premiums and Programs

Extra Help:

Beginning January 1, 2011, some people on Medicare who are getting Extra Help paying the premium for Medicare Part D and co-pays for prescriptions may lose that benefit. If they no longer qualify for Medicaid, no longer belong to a Medicare Savings Program (MSP) or no longer receive Supplemental Security Income (SSI) they will not be automatically eligible.

However, many people may still benefit from Extra Help even if they do not automatically qualify. The income and resource guidelines are as follows:

Monthly Income Limit: Individual $1,354 Married $1.821

Resources (not counting residence and cars) Individual $12,510 Married $25,010

If you or someone you know might be eligible for this Extra Help call our office and let us help you complete an application. There is no charge for applying and it can certainly save you lots of money if you are eligible.

Redetermination Letter:

You may receive a redetermination letter from Social Security Administration (SSA) form 1026-rede. If you receive this letter you MUST return it to them within 30 days of the date you receive it even if your situation has not changed. This is the form SSA will use to determine whether or not your financial situation has changed. The information may result in you receiving more, or less, Extra Help or it may stay the same but whatever the case you MUST return the completed form within 30 days of receiving it.

Do-Nut Hole:

If you are in the coverage gap (do-nut hole) or get into it before the end of the year you will receive a check from the government for $250. You do not have to do anything, this check will come automatically. If you receive a phone call requesting information in order to receive your check hang up the phone because there are no questions to answer, no information to give out. The government knows who is due the check and it will come to those who are in the do-nut hole. It may take up to three months to get the check but it will come.

Prescription Drug Program:

The new plan information and opportunity to change plans if necessary for the Prescription Drug programs will be available November 15. The sign up period will run through Dec. 31 this year.

You will receive a letter from your current plan stating what the premium will be and what drugs they will cover next year. You should look at the list of drugs they cover and make sure the drugs you take are listed. If the plan will not meet your needs or if the premium is too high you might want to check and see what other type of plan might work better for you.

We, at SEMO Area Agency on Aging, will be happy to assist you with changing plans if you decide you need to do so. As you can imagine there will be a lot of people wanting to make changes. We would like to get a head start on helping with those changes. If you need our assistance it would help us if you would make a list of the drugs you take, the strength and how often you take the drug and mail it to us now. That way we can go ahead and put your medications into the system. Then beginning Nov. 15 we can start the plan comparison. If you decide to do this please include your address and phone number so we can contact you with the results.