Last updated on: November 08, 2022
The unfortunate reality in this country is that we always have to worry about finances, even in regards to our health(especially in Kentucky). Before we can get the healthcare services we need, we must make sure we can afford them. Before we can schedule an appointment, we have to make sure insurance will cover it. Fortunately, there are some programs in place that can help you with your Medicare costs in KY. If you have any questions or need help in any way, contact Enroll Medicare. We’re always happy to help!
What is Extra Help in Kentucky?
Extra Help is a program that provides financial assistance for people with limited income so they can more easily afford prescription drug costs, premiums, deductibles, and coinsurance. This financial assistance in Kentucky is based on income and need. It’s often referred to as the Part D Low-Income Subsidy.
Medicare Part D, the prescription drug plan, can be incredibly helpful for people because of the help it offers in paying for prescription medications. However, Plan D has several costs associated with it, including deductibles and co-pays. This can create problems for individuals in Kentucky who have low income or those who are financially unstable. Medicare provides almost $4,900 annually to a person who qualifies. This amount is limited to prescription drug coverage only.
Income And Resource Limits in Kentucky For Extra Help.
The Extra Help program aims to help people with limited resources pay for their medications and premiums. In order to qualify in KY, you must meet specific income requirements based on your income and your resources.
As of 2021, the individual income limit in KY for Extra Help is $19,320 annually. If you are married and living with your spouse, the joint income limit is $26,130 annually. The resource limit for individuals and a married couple living together is $14,790 and $29,520, respectively.
Resources include the following:
- Any real estate you own besides your primary residence
- Bank accounts, including savings and checking
- Stocks
- Mutual funds
- Bonds, including U.S. savings bonds
- Individual Retirement Accounts (IRAs)
- Cash at home or anywhere else
Who Qualifies For Extra Help in Kentucky?
- Full Medicaid Benefits & Live In An Institution. If you have full Medicaid benefits and you live in an institution, such as a nursing home in KY, you automatically qualify for Extra Help. You will not have to pay a premium or a deductible, and you won’t have to pay anything for your prescription medications.
- Full Medicaid Benefits & Home & Community Based Services. If you meet these criteria, you automatically qualify for Extra Help. Again, you will not have to pay a premium or a deductible, and you won’t have to pay anything for your prescription medications.
- Full Medicaid Benefits & Meet Income Limit. If you have full Medicaid benefits and you make no more than $19,320 individually or $26,130 for couples, you qualify automatically. You will pay no premium or deductible. However, there will be a small fee for your prescription medications. You will be responsible for $3.60 for generic drugs and $8.95 for brand-name drugs. Once you reach the donut hole, you won’t owe anything.
- Full Medicaid Benefits But You Make More Than The Limit. If you have full Medicaid benefits but you make more than $19,320 individually, or $26,130 for couples, you still qualify for full Extra Help automatically. You will be responsible for $3.60 for generic drugs and $8.95 for brand-name drugs. Once you reach the donut hole, you won’t owe anything.
- You Meet Income Limit. If you don’t have Medicaid benefits, but your income is no higher than $19,320 individually or $26,130 for couples, you qualify for the full amount of Extra Help, but you must apply for it. You will be responsible for $3.60 for generic drugs and $8.95 for brand-name drugs. Once you reach the donut hole, you won’t owe anything.
How To Apply For Extra Help in Kentucky
Applying for Extra Help in Kentucky is simple. All you have to do is complete the application through Social Security. You can use one of these methods to apply:
- Call Social Security to apply over the phone or request a paper application
- Apply online at www.ssa.gov/extrahelp
- Apply at your local Social Security office
- Contact Enroll Medicare, and we can help you!
After you apply, your application will be reviewed by Social Security, and you will receive a letter if you qualify for Extra Help.
What You Should Do Before You Apply in Kentucky
Most questions in the application are about income and resources. To prepare, you should do the following:
- Review all your household income
- Gather all records in advance to save some time
- Identify the things you own by yourself, with your partner/spouse, or with someone else. You do not need to include your home, vehicles, burial plots, life insurance policies, or personal possessions.
After You Apply
After you apply for Extra Help, you should hear from Social Security within 60 days of the date that they received your application. You will receive either a notice of award, informing you that you qualify for full or partial extra help, or you will receive a notice of denial, informing you that you do not qualify. The denial notice will explain why you don’t qualify and how to appeal the decision if you disagree with it.
Enroll Medicare Can Help in Kentucky
If you are struggling to afford your prescription medications, we are here to help. We can help get you signed up for Extra Help at any time. We have experienced staff in Kentucky who can walk you through the process step-by-step. Contact us today so we can help you save as much money as possible while prioritizing your health.
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