Renewing Extra Help

Q: I just went to the pharmacy for my regular medications, and I was told that I no longer have Extra Help. What happened? What should I do?

A: If you applied for Extra Help in the past, Social Security may have mailed you a letter around August – September called a Social Security Administration Review. This would have included a form outlining the financial and personal information you provided when you applied and asked if any of it has changed. If you and your spouse applied for Extra Help on the same application, you will receive only one letter.

Social Security will use your answers to decide if you are still qualified for Extra Help and how much Extra Help you should get. If you need more time to fill out the form, call your local Social Security office and ask for an extension; you may receive an extra 30 days to fill out the form. Any changes to your Extra Help assistance will go into effect on January 1.

If you do not return the Review of Your Eligibility form, Medicare will assume that you no longer qualify for Extra Help and your assistance will end on December 31.

Not everyone who applied for Extra Help will receive a letter.

If you got Extra Help automatically because you were already enrolled in Medicaid, a Medicare Savings Program (MSP), or were receiving Supplemental Security Income (SSI), AND are still enrolled in Medicaid or an MSP, or receiving SSI in the Fall, your state should tell Medicare that you are still enrolled in one of these programs. You should not receive any notice unless your copayments are changing for the next year. If your income changed enough to affect your copayments, you should have received a notice telling you this in October.

Three important things you need to know:

  1. Your current drug plan also should contact you to let them know how much their drug coverage will cost after losing LIS
  2. You have a three-month special enrollment period to enroll in a drug plan with a less expensive premium if you choose
  3. You can file an appeal with SSA or reapply for Extra Help

You should contact SSA right away to file an appeal if you disagree with their decision. Appeals can be made within 60 days of receiving the dated letter from SSA. Only those who file an appeal within the first 10 days will continue to receive the Extra Help while their appeal is waiting decision. Beneficiaries may re-apply for Extra Help with SSA or Medicaid/MSP at any time in the future.

For assistance with your Extra Help questions, or any other questions about Medicare, call SHIP at 1-800-452-4800, 1-866-846-0139 TDD or online at www.medicare.in.gov.