Frequently Asked Questions About Extra Help
Can you qualify if your income is slightly over the limit?
Yes, you might still qualify because the Social Security Administration excludes certain portions of your income. In addition to the $20 monthly unearned income disregard, the government disregards the first $65 of monthly earned wages plus half of your earnings above $65.
Certain state-administered programs and disability assistance payments are also excluded from countable income. You should always submit an application even if you believe your earnings sit slightly above the posted limits.
Does Extra Help pay for Medicare Part B premiums?
No, Extra Help applies exclusively to Medicare Part D prescription drug costs. It does not pay your monthly Medicare Part B premium, which covers doctor visits and outpatient care.
To obtain help paying your Part B premium, apply for a Medicare Savings Program through your state Medicaid office. Qualifying for a Medicare Savings Program often triggers automatic approval for Extra Help as well.
What happens to Part D late enrollment penalties once approved?
The federal government permanently waives Part D late enrollment penalties once you qualify for Extra Help. Any penalty accumulated from past gaps in creditable prescription coverage is eliminated.
You will pay no penalty fees as long as you maintain Extra Help status. If your subsidy ends in the future, past penalties will not be retroactively billed to your account.
How often does the government review your Extra Help eligibility?
The Social Security Administration reviews eligibility annually, typically during late summer or early autumn. The agency checks IRS tax data to verify your ongoing income and asset qualifications.
If your financial circumstances have not changed, your benefits continue automatically into the next year. If the agency requires updated information, it will mail you an eligibility review form that you must complete within 30 days.
HealthyHabits.care is an independent publication and is not connected with or endorsed by the U.S. government or the federal Medicare program. This article is general information, not insurance or legal advice. For free, unbiased help with your coverage, contact your State Health Insurance Assistance Program (SHIP) or call 1-800-MEDICARE.
