Extra Help and Medicare Savings Programs for Baltimore residents

Lots of people in Baltimore are paying more for Medicare than they need to, simply because nobody told them about the programs that help. There are two main ones: Extra Help for prescription costs, and Medicare Savings Programs for premiums and other costs. Whether you qualify depends on your income and resources, and we cannot promise any result. What we can do is show you what exists and where to apply.

Extra Help with prescription costs

Extra Help, sometimes called the Part D Low-Income Subsidy, is a federal program that helps pay Part D drug plan costs for people with limited income and resources. Depending on your situation, it can lower your drug plan premium, your deductible and what you pay at the pharmacy. You apply through Social Security, and Social Security decides whether you qualify.

Here is the part many people miss. If you already have Medicaid or get help from a Medicare Savings Program, you generally qualify for Extra Help automatically. You may receive a notice about it in the mail. Keep it, because it matters when you pick a drug plan.

Medicare Savings Programs

Medicare Savings Programs are run through your state Medicaid agency. In Maryland, that is Maryland Medicaid. There are several levels, and the names you will see are QMB, SLMB and QI. In general, they can help pay your Part B premium, and one level can also help with deductibles and copays. Each has its own income and resource limits, which are updated every year.

Three myths we hear

• "I own my home, so I will not qualify." The home you live in is usually not counted toward the resource limits for Extra Help. Rules differ by program, so ask before you rule yourself out.
• "My income is a little too high." Limits change every year, and the best way to know is to ask. Not everyone who qualifies knows it.
• "Applying is too much trouble." It takes some paperwork, but it is usually manageable. Having the right documents ready makes it far easier.

What to gather before you apply

1. Your Medicare card and a photo ID
2. Proof of income, such as a Social Security award letter or pension statement
3. Recent bank statements and any other account statements
4. Any letters you have received from Social Security or Maryland Medicaid
5. A list of your medications and your pharmacy

Why it pays to check every year

Income, household size and program rules change over time, so a "no" a few years ago is not always a "no" today. If your situation changes, such as a lower income after retirement or a spouse passing away, it is worth asking again. Keep any notices you receive, and bring them to your annual plan review so nothing gets overlooked.

How these programs affect your plan choice

If you get Extra Help or Medicaid, your best Medicare plan may not be the same as someone else's. A drug plan that works well for one person can cost another far more. People with both Medicare and Medicaid can also look at D-SNP plans. We compare options each year, and we explain both the benefits and the downsides.

It also helps to understand the bigger picture of how Medicare and Medicaid work together.

Final thoughts

Related guides

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D-SNP plans

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Medicaid

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Who pays first, and what Medicaid may add.

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