The State Health Insurance Assistance Program (SHIP) has recently received information from Centers for Medicare and Medicaid Services (CMS) regarding 515 people who reside in DeKalb County who may qualify for additional help with their Medicare costs. This is the number of residents who may not currently be paying low co-pays at the pharmacy as well as get assistance paying their Part B premiums. The Extra Help Program (also called Low-Income Subsidy) is a program that is processed by Social Security Administration which helps certain low-income beneficiaries by paying zero dollar monthly premiums, no deductibles and very low cost share at the pharmacy. This program also eliminates the coverage gap, or as most calls it, the “donut hole.” The extra help program is valued up to $3,900.00 per year per beneficiary as well as the possibility of getting back the Part B premium which is $96.40 (for most individuals) and deducted out of SSA checks automatically.
The SHIP program can assist any beneficiary with Medicare by helping with the application process electronically. Many people in DeKalb County already qualify for the “extra help” due to the fact that they already receive TennCare or SSI benefits and therefore do not need to apply each year. For others who meet certain income and asset guidelines, the application process is easy and submitted to Social Security electronically through www.ssa.gov. The great thing about applying online is that once the application is reviewed by SSA, it is then sent to the state Medicaid office with the individual’s permission to see if they qualify to get assistance paying the Part B Premium which is called a “Medicare Savings Program.”
Many people who debate applying should do so anyway. Most people automatically assume they do not qualify because they have always been denied for other programs for making a little too much and have become tired of being told no for the smallest benefits. There are no estate recovery or recapture penalties to this benefit. An individual must have a monthly income of $1,354 or less (1,821 for a married couple) to qualify for the extra help. Having additional family members may make this amount higher. Resource (asset) limits are below $12,510 for single and $25,010 for a couple. Please note that a person’s home, car and personal possessions are not looked at. Resources, or assets, can include other properties, savings or checking accounts, certificates of deposits and cash value of any IRA’s or annuities. Due to new MIPPA laws, (Medicare Improvements for Patients and Providers Act of 2008), the application can no longer ask for cash value of life insurance policies nor ask for value of any help provided by others to help pay monthly expenses.
If you think you may qualify for the extra help paying Part B or Part D costs, or, you know someone who may, please call SHIP for free assistance in applying at toll free 1-877-801-0044. SHIP is a non-profit program which is administered locally at Upper Cumberland Development District in Cookeville. SHIP provides free, non-biased information on all Medicare topics to beneficiaries and their caregivers throughout the Upper Cumberland fourteen counties. We are currently seeking volunteers to help us with the challenge of helping find the 310 individuals in DeKalb County. Please call (931) 432-4111 ext. 247 if you are interested in volunteering with the SHIP Program.
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