If you have Medicaid, low income or limited assets, you may qualify for Extra Help from Medicare (also known as a low-income subsidy or LIS) to pay for prescription drug costs. Medicare could pay for up to 100% of your monthly prescription drug premiums, annual deductibles and coinsurance.
To find out if you are eligible for Extra Help or to learn more about it, you can call us at 1-800-967-4497 (TTY: 711) and talk to one of our Medicare Specialists. Our agents are available from 8 a.m. to 8 p.m. seven days per week from Oct. 1 through March 31 (except Thanksgiving Day and Christmas Day) and 8 a.m. to 8 p.m. Monday through Friday from April 1 through Sept. 30.
You can also learn if you are eligible for Extra Help by contacting Medicare or the Social Security Office at the phone numbers listed below or by contacting your state Medicaid office.
TTY: 1-877-486-2048 (for hearing impaired)
Available 24 hours per day, seven days a week
TTY: 1-800-325-0778 (for hearing impaired)
7 a.m. – 7 p.m. Monday through Friday
Qualifying for Extra Help
To qualify for Extra Help, your income must be limited to $14,790 for an individual or $29,520 for a married couple living together, based on 2021 requirements. During the application process, you may need to provide information about your income as well as other resources of value, including real estate excluding your primary residence, bank accounts, retirement accounts, stocks, bonds and cash at home or anywhere else.
Some of the resources that do not count when being evaluated for Extra Help include:
- food stamps
- housing assistance
- home energy assistance
- medical treatment
- disaster assistance
- earned income tax credit payments
- assistance from others to pay household expenses
- scholarship and education grants
You may have other exclusions so contact Social Security for more information.
2021 LIS premium chart
If you get Extra Help from Medicare to pay for your Medicare prescription drug plan costs, your monthly premium will be lower than what it would be without Extra Help. The amount of Extra Help you get will determine what you pay per month as a member of the WellSense Medicare Advantage plan.
This table shows the monthly premium for the WellSense Medicare Advantage HMO starting Jan. 1, 2022 based on the amount of Extra Help you receive. The amount includes coverage for both medical services and prescription drugs, as well as all of the extra benefits that come with our plan. It does not include any Medicare Part B premium you may have to pay. You must continue to pay your Medicare Part B premium and any other applicable Medicare premium(s) if Medicaid or a third party does not already pay them. This table does not include any Medicare Part B premium you may have to pay.
|Level of Extra Help||Monthly premium for WellSense Medicare Advantage Plan|
If you have any questions regarding your eligibility for Extra Help or the amount of the premium for our plan, please call 1-800-967-4497 (TTY 711) to speak to one of our licensed agents. We are open from 8 a.m. to 8 p.m. seven days per week from Oct. 1 through March 31 (except Thanksgiving Day and Christmas Day) and 8 a.m. to 8 p.m. Monday through Friday from April 1 through Sept. 30.