Medicare Part D (Prescription Drug) Open Season & Extra Help

The Medicare Part D (prescription drug coverage) plan open enrollment period started October 15 and ends December 7.

Learn about Part D at the Medicare website, www.medicare.gov.  The Medicare homepage shows the Open Enrollment dates with a link labeled “Review your health and drug coverage options” that takes you to the Medicare Plan Finder. There you can complete a general search of plans in your ZIP code or a more detailed search based on more personal information. The 2016 plans are now available to review and compare.

Medicare-PtDwebsite

Review your existing Part D plan each year. Insurance plans and your specific needs change. A plan that previously fit your needs might not be your best choice now. You need a list of your medicines, including dosages and frequency, to compare plans. Spouses can choose different plans.

Social Security representatives cannot help you choose a Part D prescription drug plan. Along with the official Medicare website tools to help you, state agencies might be available to help you. The North Dakota Insurance Department website has a schedule of statewide Part D enrollment events and the Minnesota Board of Aging, Health Insurance Counseling Program, helps too.

The Part D (Drug Coverage) page of the Medicare website contains a “Find someone to talk to” link, usually the State Health Insurance Assistance Program (SHIP) and others.

Everyone currently enrolled in Medicare can purchase a Part D prescription drug plan. Unlike Medicare Part A (Hospital) or Part B (Medical), Part D plans are purchased through private insurers. You shop for the plan that best suits your needs. Joining a Medicare prescription drug plan is voluntary and participants pay an additional monthly premium for the coverage.

Although Social Security representatives cannot help you choose a Part D plan, the agency does administer the Extra Help portion of Medicare Part D for people with limited income and resources.

Extra Help is an income and resource based subsidy to help pay for part of monthly premiums, annual deductibles, and prescription co-payments. More about Extra Help is at http://www.socialsecurity.gov/medicare/prescriptionhelp/.

Financial requirements for the Prescription Drug Coverage Extra Help vary in part if you have earnings, support other family members or if you live in Alaska or Hawaii. General  requirements  include that:

Your resources must be limited to $13,640 for an individual or $27,250 for a married couple living together. Resources include such things as bank accounts, stocks and bonds. We do not count your home, car or any life insurance policy as resources; and

Your annual income must be limited to $17,655 for an individual or $23,895 for a married couple living together. Even if your annual income is higher, you still may be able to get some help. Some examples where you may have higher income and still qualify for Extra Help include if you or your spouse: Support other family members who live with you, have earnings from work, or live in Alaska or Hawaii.  

The Extra Help website page has a section to help you decide if you might qualify for Extra Help assistance and has a list of information that you will need.  Follow the See if you qualify for Extra Help and apply link to use this. Keep in mind that using only the “Find out if you qualify” tool” is not an application and does not provide a formal decision. An Extra Help application can be completed regardless of the “see if you qualify” results. Complete an Extra Help application at the same link if desired.

An Extra Help application can be completed at any time, not only during the Part D open enrollment period. 

People with Medicare and receiving Supplemental Security Income (SSI) are automatically eligible for Extra Help and should not apply.

Applying for the Part D Extra Help program does not enroll you in a prescription drug plan. Enrolling in a Part D prescription drug plan is separate and different from applying for the Extra Help program.

You can also call the SSA national toll-free number, 1-800-772-1213 (TTY 1-800-325-0778), or your local office for Part D Extra Help information and to apply.

Part D Exta Help