MEET & GREET With Jill
Jill Clifford , Managing Agent
Join Jill at one of her local upcoming events!
Jill Will Be Covering:
* "ABCD's of Medicare" * Free Educational event on the basics of Medicare and your choices for coverage
* No cost nor obligation
MEET & GREET
Attend One Of Jill's Local Workshops and Receive Updates and Announcements 100% FREE!
September 26, 2024
10 am - noon
Auburn Annual Health Fair
Auburn Senior Center Gym 808 9th St SE, Auburn, WA 98002
October 5, 2024
1 pm - 2:30 PM
Auburn Public Library
1102 Auburn Way S,
Auburn, WA 98002
October 24, 2024
11 am - 2:00 PM
Health & Wellness Fair
25035 104th Ave SEKent, WA 98030
Sponsored By:Cogir of Kent, Senior Living
Articles Quick Access
The ABCD’s of Medicare – Extra Help and Medicaid by Jill Clifford
Today we’ll cover the Extra Help program for prescription drugs and Medicare Savings Program, also known as Medicaid. You or someone you know may be eligible.
Extra Help, administered through Social Security, could save thousands of dollars in prescription drug costs. Many eligible people may be unaware of these benefits or how to get them. To be eligible for the Extra Help, an individual or couple must be under the maximums for both assets and gross income. Assets include cash, bank and stock accounts, IRA’s, and real estate other than one’s primary home. Assets do not include the primary home, car, furniture, other personal belongings, or life insurance. Further, even if some Americans exceed income limits, they may still qualify if they are supporting other family members. Limitations:
Extra Help pays the premium of a stand-alone prescription drug plan, or the premium amount of prescription drug coverage in a Medicare Advantage Plan. It also reduces the cost of prescription drugs to no more that $4.15 for generic drugs and no more the $10.35 for all other Medicare Part D drugs. (Medicare Part B drugs are still 20% coinsurance under original Medicare, but may be covered differently under certain Medicare Advantage plans.)
To apply for the Extra Help program, you may call Social Security at 1-800-772- 1213 (TTY service at 1-800-325-0778), and they will send you a form called Social Security Administration Review of Your Eligibility for Extra Help (SSA-1026), or set up an appointment at the local Social Security Office, or apply online at www.ssa.gov/extrahelp. After applying, you will receive a qualification letter. You may also have a telephone interview. If qualified, the benefits will be in effect on the first day of the qualifying month.
Medicaid is a Federal program, funded jointly by the Federal and state governments. In Washington, the Medicaid program is called “Apple Health.” To apply for Apple Health (Medicare Savings program), there are multiple ways. An individual may apply online at https://www.wahealthplanfinder.org/ or download an application form. Applications can be taken by phone at the Washington Healthplanfinder Customer Support Center at 1-855-923-4633, or with local resources you can find on the Healthplanfinder site or by phoning the customer support center.
There are four levels of coverage under The Apple Health Medicare Savings programs, depending on the Federal Poverty Level (FPL), labeled QDWI, QI-1, SLMB, and QMB. All four include Extra Help if the assets limitation is met. However, the Apple
Health does not include assets, only income, in determining an individual's eligibility for coverage
The Qualified Disabled Working Individual(QDWI), Qualified Individual (QI-1) level and Specified Low. Income Medicare Beneficiary (SLMB) level all pay the Medicare Part B premium, which is $164.50a month in 2023. The Qualified Medicare Beneficiary (QMB) level includes payment of Part B premium and medical benefits, such as copayments or coinsurance on original Medicare and on Medicare Advantage plans. Additionally QMB individuals can enroll in Special Needs Plans, which may provide extra benefits beyond original Medicare and Medicaid.
Apple Health maximum income for qualifying levels in 2023 (per https://www.hca.wa.gov/):
Maximums change each year, and may be otherwise adjusted. Maximums may be higher under special circumstances, as when a single person or couple is caring for dependent children or elderly person(s).
