Key Takeaways

• More Medicare beneficiaries in 2024 now qualify for Extra Help, lowering out-of-pocket costs for prescription medications.
• Understanding the new eligibility guidelines could significantly reduce healthcare expenses for those who meet the updated requirements.

More Medicare Beneficiaries Will Qualify for Extra Help in 2024: Are You One?

In 2024, the Medicare Extra Help program has expanded to cover more beneficiaries, providing much-needed financial relief for prescription drug costs. This change marks a significant opportunity for individuals who previously did not qualify for assistance. With updated income and resource limits, Extra Help aims to reduce the burden of medication expenses for thousands of Medicare beneficiaries. If you’ve been wondering whether this new assistance might apply to you, it’s time to explore the changes and see if you now qualify.

What is Extra Help?

Extra Help, also known as the Low-Income Subsidy (LIS), is a federal program designed to assist Medicare beneficiaries with limited income and resources in paying for Medicare Part D prescription drug costs. The program helps reduce premiums, deductibles, and copayments, making it easier to afford necessary medications.

Since 2024, more people than ever are eligible to take advantage of Extra Help, thanks to revisions in the program’s eligibility criteria. As healthcare costs continue to rise, this change provides a critical opportunity for many who rely on Medicare for their prescription medications.

Why Are These Changes Happening in 2024?

Healthcare reform in 2024 has expanded the eligibility criteria for Extra Help to include more beneficiaries. This move is part of a broader effort to make healthcare more affordable for Medicare recipients, particularly those struggling with the high costs of prescription medications. With the updated guidelines, both income and resource limits have been adjusted, meaning that people who may have been ineligible in the past may now qualify.

Updated Income and Resource Limits

Eligibility for Extra Help is determined by both income and resources, and these thresholds have increased for 2024. The changes aim to bring financial assistance to those who need it most, easing the burden of prescription drug costs.

• Income Limits: The income limit for Extra Help has been raised to include individuals and couples with incomes up to 150% of the federal poverty level (FPL). This change means that individuals with slightly higher incomes than before may still qualify for partial assistance.

• Resource Limits: In 2024, the limits on the value of a person’s assets have also increased, allowing more individuals to qualify even if they have modest savings or investments. This includes cash in bank accounts, retirement savings, and stocks, but excludes essential items like your home or car.

These changes are designed to capture more beneficiaries who fall just above the previous thresholds, ensuring they can now access the assistance they need.

How to Know If You Qualify for Extra Help

Determining your eligibility for Extra Help in 2024 is easier than ever. The Social Security Administration (SSA) evaluates both your income and resources to see if you qualify for either full or partial Extra Help.

Full Extra Help

Those who qualify for full Extra Help will have nearly all their prescription drug costs covered, including premiums and deductibles for Medicare Part D. Full Extra Help is available to individuals whose income is at or below 135% of the FPL and whose resources fall below a certain threshold. In 2024, more people than ever will qualify for this full level of assistance due to the expanded income and resource limits.

Partial Extra Help

For individuals whose income or resources slightly exceed the limits for full Extra Help, partial assistance is available. This level of assistance still offers significant savings, though beneficiaries may have to pay reduced premiums and deductibles. Even with partial Extra Help, your out-of-pocket costs will be much lower than if you weren’t receiving any assistance at all.

Applying for Extra Help in 2024

If you believe you might be eligible for Extra Help, the application process is straightforward and accessible. Beneficiaries can apply online through the SSA website or by submitting a paper application. The SSA will review your financial situation and notify you if you qualify.

Here are some tips for applying:

1. Accurately Report Your Income: Include all sources of income such as Social Security benefits, pensions, and wages.

2. Understand What Resources Are Counted: The SSA considers things like savings accounts, stocks, and bonds, but excludes your home, vehicle, and personal possessions.

3. Reapply if Your Circumstances Change: Even if you’ve been denied Extra Help in the past, it’s worth applying again in 2024. The expanded eligibility limits could mean that you now qualify for assistance.

How Extra Help Impacts Your Prescription Drug Costs

For those who qualify, the Extra Help program offers significant savings on prescription medications. Medicare beneficiaries enrolled in Part D typically pay premiums, deductibles, and copayments for their prescriptions. Extra Help reduces these costs, sometimes covering them entirely for those who qualify for full assistance.

Lowering Out-of-Pocket Costs

The financial relief provided by Extra Help can be substantial. For example, individuals who qualify for full Extra Help often pay little to nothing for their medications. This is particularly important for people who take multiple prescriptions or rely on expensive medications for chronic conditions like diabetes, heart disease, or cancer.

Additionally, Extra Help eliminates the coverage gap, commonly referred to as the “donut hole,” where beneficiaries usually face higher out-of-pocket costs. With Extra Help, you’re protected from these increased costs, meaning you can get your medications throughout the year without worrying about a sudden spike in expenses.

What If You Don’t Qualify?

If you find that you don’t qualify for Extra Help under the new 2024 guidelines, there are still options available to help manage your prescription drug costs.

Consider Switching Plans

During Medicare’s Annual Enrollment Period (AEP), you have the option to switch your Medicare Part D plan. By comparing available plans, you may find one with lower premiums, deductibles, or copayments. This can help reduce your overall prescription costs even if you don’t qualify for Extra Help.

Pharmaceutical Assistance Programs

Many pharmaceutical companies offer assistance programs for individuals who cannot afford their medications. These programs often provide discounts or even free medications to eligible individuals. It’s worth investigating whether your prescriptions are covered under such a program.

State Assistance Programs

Some states offer additional financial assistance to Medicare beneficiaries. These programs vary by state but can include help with prescription drug costs, premiums, or even copayments. Contact your state’s health department or visit their website to see if additional support is available in your area.

The Long-Term Benefits of Extra Help

Qualifying for Extra Help in 2024 can provide ongoing financial relief. With prescription drug costs continuing to rise, the ability to access affordable medication is more critical than ever. For seniors living on fixed incomes, Extra Help can mean the difference between affording necessary healthcare and having to skip essential medications.

By lowering prescription drug costs, Extra Help improves the quality of life for many Medicare beneficiaries. This assistance ensures that individuals can adhere to their prescribed treatment regimens without worrying about how to pay for their next refill. Over time, this leads to better health outcomes, reduced hospitalizations, and lower overall healthcare costs.

What Should You Do Next?

If you think you might be eligible for Extra Help in 2024, now is the time to act. Here are the steps you should take:

1. Check Your Eligibility: Review your income and resources to see if you fall within the new limits. Remember that income and assets like your home and car aren’t counted.

2. Apply Through Social Security: Submit an application online through the Social Security Administration website or visit your local office.

3. Follow Up: Once you’ve submitted your application, watch for a response from the SSA. If you qualify, your Medicare Part D costs will be adjusted automatically.

Applying for Extra Help is a simple process that can result in significant savings on your prescription drug costs. Don’t wait to take advantage of this expanded program in 2024.

More Medicare Beneficiaries Qualify for Help in 2024

The expansion of the Extra Help program in 2024 means that more Medicare beneficiaries will now qualify for financial assistance. This change provides an important opportunity for individuals who struggle with the high costs of prescription medications. If you’re unsure whether you qualify, it’s worth checking—this assistance could make a big difference in your healthcare expenses.