You can receive a certain amount of monthly income, which includes your Social Security benefits, and still qualify for "Extra Help" to cover Medicare prescription drug costs. For 2024, your total monthly income must be up to $1,903 for an individual or $2,575 for a married couple living together to be potentially eligible for this assistance, provided your assets also meet specific limits.
Extra Help is a federal program designed to assist people with limited income and resources pay for their Medicare Part D prescription drug plan premiums, deductibles, coinsurance, and copayments. While Social Security benefits are often a primary source of income for many seniors and individuals with disabilities, Extra Help considers your total monthly income from all sources, not just Social Security.
Understanding Extra Help Eligibility
To qualify for Extra Help, both your income and your assets (resources) must fall below certain thresholds.
Income Limits
The income limits for Extra Help can change annually. It's crucial to check the most current figures, but based on 2024 data:
| Category | 2024 Monthly Income Limit |
|---|---|
| Individual | Up to $1,903 |
| Married Couple | Up to $2,575 (living together) |
It's important to note that certain types of income may be excluded when calculating your eligibility, such as specific veterans' benefits, food stamps, or housing assistance.
Asset Limits
In addition to income, your assets (also known as resources) are also evaluated. Assets include money in checking or savings accounts, stocks, bonds, and mutual funds. Your home and car generally do not count as assets.
For 2024, the asset limits are:
- Individual: Up to $17,220
- Married Couple: Up to $34,360
These limits are designed to ensure that the program helps those with the greatest financial need.
How Social Security Benefits Affect Eligibility
Your Social Security benefits are counted as part of your total monthly income. For example, if your only income is a Social Security benefit of $1,500 per month, and you meet the asset limits, you would likely qualify for some level of Extra Help. If you also have a pension, part-time job earnings, or other income, all these sources combined must not exceed the specified monthly income limit.
Benefits of Extra Help
Qualifying for Extra Help can significantly reduce your healthcare costs. Depending on your income and assets, Extra Help can help you by:
- Lowering or eliminating your Medicare Part D premium: Many plans have their premiums covered entirely.
- Reducing your deductible: The amount you pay before your plan starts to pay.
- Limiting your copayments and coinsurance: The amounts you pay for each prescription.
- Eliminating the "donut hole" (coverage gap): This means you continue to receive help with drug costs even after reaching certain spending thresholds.
Applying for Extra Help
You can apply for Extra Help through the Social Security Administration (SSA). The application process involves providing information about your income, assets, and household situation. Even if you think your income or assets might be slightly above the limits, it's often worth applying, as there are specific exclusions and considerations that might make you eligible.
