Medicare : Extra Help Details

Depending on your level of Extra Help, you will pay no more than the following for generic and brand name drugs:
 

• A $0 (generic and brand) copay; or
• A $1.10 (generic) or $3.30 (brand) copay; or
• A $2.60 (generic) or $6.50 (brand) copay; or
• 15% coinsurance (generic and brand)
   

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly Part D plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly Part D plan premium as a member of our Plan.

See what the monthly plan premiums are for those who qualify for Extra Help in our plans, by locating your state below:

 

• Connecticut  (Spanish)
• Florida   (Spanish)
• Georgia  (Spanish)
• Illinois  (Spanish)
• Louisiana 
• Missouri 
• New Jersey  (Spanish)
• New York  (Spanish)  (Chinese)
• Ohio 
• Texas  (Spanish)

 

This does not include any Medicare Part B premium you may have to pay.
 

Premiums, deductibles and co-pays may vary based on the level of extra help you receive. Contact us for details.
 

State Pharmacy Assistance Programs
A State Pharmaceutical Assistance Program (SPAP) provides state funded prescription drug assistance to people who need help paying for their monthly prescription drug plan premiums, deductibles, copays and coinsurance. For most programs, members must meet specific criteria to be eligible that vary by program.

To find out if there is an SPAP in your state, please review the Evidence of Coverage or call your State Health Insurance Assistance Program (SHIP).

Medicaid
Medicaid is a joint Federal and state program that helps pay medical costs for some people with limited income and resources.
 

• Most health care costs are covered if you have Medicare and Medicaid.
• Medicaid programs (and income limits) vary from state to state.
• Medicaid may offer coverage for services that aren’t fully covered by Medicare, such as nursing home and home health care.

Last modified: 05/18/2012