Case Flash: Continuing Extra Help Eligibility From One Year to the Next

Mr. L has Original Medicare Parts A and B and a stand-alone Part D prescription drug plan. In November of last year, he applied for Extra Help, the federal program that helps with most of the costs of Medicare Part D coverage. Mr. L qualified for partial Extra Help, which reduced his Part D premium, deductible and copayments for all of 2008. However, Mr. L recently received a letter in the mail letting him know that his Extra Help would end on December 31 st.

Mr. L called the Medicare Rights Center hotline and spoke with a counselor about his Extra Help status. The counselor assessed that Mr. L’s income and assets had not changed significantly and that he should still be eligible for Extra Help in 2009. The hotline counselor then asked Mr. L whether he had received a form from Social Security called “Review of Your Eligibility for Extra Help.” The counselor explained that when you apply for Extra Help, Social Security will sometimes send out a form in August or September to assess whether you continue to qualify for Extra Help. Not everyone gets the form, but those who do receive it must fill it out. If the form is not returned, Extra Help will not be recertified and the assistance will stop at the end of the year.

Mr. L looked through his old mail and found that he had received a recertification letter, but since his income and assets had not changed, he had not realized that he needed to return the enclosed form to Social Security. The counselor told Mr. L that even though his Extra Help was set to end, he could reapply for assistance for the following year by going in person to his local Social Security office, or by applying online at www.ssa.gov. The counselor advised Mr. L to reapply as soon as possible to ensure that his Extra Help coverage continues in January 2009. Mr. L took the counselor’s advice and went to his local Social Security office that day to reapply for Extra Help for the following year. Four weeks later, he was notified that he would again have partial Extra Help coverage for the year in 2009.

-Adapted from “ Case Flash: Continuing Extra Help Eligibility From One Year To The Next” in MEDICARE WATCH, a biweekly electronic newsletter of the Medicare Rights Center, Vol. 11 , No. 26: December 23, 2008.

 

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