Glossary Term

Extra Help

Extra Help is a program run by the Social Security Administration that reduces the expense of Medicare Part D premiums and out-of-pocket costs for qualifying individuals. The value of this assistance can amount to thousands of dollars annually.

Extra Help is also known as the Low-Income Subsidy program because the program aims to assist individuals with limited financial means. Medicare beneficiaries with eligible income and asset levels may apply for participation in the program. Some individuals automatically qualify for the program without need of application. These groups include people who are dual eligible as well as Medicare beneficiaries who receive Supplemental Security Income (SSI).

Another benefit of the Extra Help program is that it waives the Medicare Late Enrollment Penalty. The Late Enrollment Penalty is a Part D premium increase of one percent per month that a Medicare beneficiary was eligible for Part D insurance but did not have creditable coverage. The one percent is not derived from the beneficiary’s own Part D plan but the base nationwide premium the Medicare program. In practice, this means if a Medicare beneficiary missed his Part D open enrollment period but enrolled during the next enrollment period one year later, he would pay his normal monthly premium plus an additional charge of 12 percent for the 12 months without Part D coverage. This charge would continue for the rest of his life. However, if this same individual qualified for the Extra Help program, the Late Enrollment Penalty would be waived while he remained eligible for Extra Help

The Extra Help program is available throughout the United States but not in the five American territories: Guam, American Samoa, the U.S. Virgin Islands, the Northern Mariana Islands, and Puerto Rico.

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