Help with Medicare Costs

There are two ways to apply for help with Medicare costs and prescription drugs. A person on Medicare can apply through the state Medicaid Program or go through Social Security. I recently helped a lady apply for help through the Social Security website, SSA.gov. Within two weeks she got a letter telling her she qualifies for help with her drug costs.

Rosa is turning 65 in April and is still working. Rosa is collecting Social Security, and if this was her only income she would qualify for the maximum help with her Medicare and prescription drug costs.  Because Rosa’s case is a bit complicated with her two income sources, I figured the best way to ask for help was through SSA.gov.  So we got on the computer, went to SSA.gov  and clicked on the link that says “Get extra help with Medicare prescription drug costs”.

We answered a few questions, hit apply, and Rosa’s request for help was submitted. She had given Social Security permission to check her income tax records which would be used to see if her income is low enough to qualify for help.

About two weeks later, Rosa received a letter from Social Security. I went by her house to look at the letter because the language is not real clear about what level of help she might get. The good news is that she qualifies for the maximum subsidy for her drug costs. That means she will pay $6.60 for brand drugs and $2.65 for generics. This help is called the “Low Income Subsidy”.

The letter showed Rosa how Social Security calculated her income, which (as far as I can tell) says her income is around $1,300 per month.  The letter said Social Security will pass on this information to the State of Arizona to see if she qualifies for help paying her Medicare Part B premium. But $1,300 per month is a bit too high to get this help (as far as I know). So I told Rosa to call me when she gets the letter from AHCCCS (Arizona Health Care Cost Containment System).

A person can apply through their state Medicaid office for help.

Another way to apply for help with Medicare costs and drug costs is to go through AHCCCS (in Arizona). But my experience with AHCCCS has taught me the following:

1) Never go through DES. ALTCS (Arizona Long Term Care System) handles applications for the Medicare Savings Program.

2) The state cannot process an application for help more than one-month before a person’s Medicare is set to begin.

3) If a person is not yet collecting Social Security, the state office can’t deal with their application. I think the same can be said if a person is still working.

4) The state of Arizona does not care if a person has money in the bank, while Social Security does care. So if a person has some savings, but is only living on their Social Security benefits, it is best to apply through the state of Arizona. Social Security will reject an application from a person who has more than $13,300 in savings or a couple with more than $26,580 in savings and investments.

For a short video on who gets help, check out my web page.

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