Managing Your Coverage After Approval
Receiving your award letter is a major relief, but you must take a few ongoing steps to maximize your savings. Ensuring your plan coordinates properly with the subsidy protects your wallet.
Selecting a Benchmark Plan
Extra Help covers the basic premium only if you join a “benchmark” prescription drug plan. If your current plan charges above the regional benchmark threshold, you must pay the premium difference yourself.
Each autumn, review your Medicare Annual Notice of Change to verify whether your current plan will maintain its benchmark status.
You can identify $0-premium benchmark plans using the official Medicare Plan Finder on Medicare.gov. Filter your plan results to show Part D plans that cost $0 per month with Extra Help.
Using Your Special Enrollment Period
Qualifying for Extra Help grants you a Special Enrollment Period (SEP) to adjust your coverage. You do not have to wait for the standard fall Open Enrollment period to fix a problem.
You can switch your stand-alone Part D plan or Medicare Advantage plan once per calendar quarter during the first nine months of the year. Any plan change you make takes effect on the first day of the following month.
Reporting Life and Financial Changes
You must inform the Social Security Administration if your living arrangements or financial status change significantly. Events like marriage, divorce, or receiving a financial inheritance alter your eligibility.
Every year, the government audits a portion of Extra Help recipients to verify ongoing qualification. If you receive Form SSA-1026 in the mail, fill it out and return it promptly to avoid losing your benefits.
If you need personalized guidance selecting a plan, reach out to the State Health Insurance Assistance Program (SHIP). SHIP provides free, unbiased counseling to Medicare beneficiaries and their families nationwide.
