Is extra help the same as Medicaid?

Asked by: Dr. Vladimir Stehr II  |  Last update: August 5, 2025
Score: 4.5/5 (62 votes)

“Extra Help” supports people who are on Medicare and also qualify for their state's Medicaid program. 2024 benefits include: No or reduced monthly premium. No annual deductible.

What is extra help also known as?

This page contains information on eligibility for the Low-Income Subsidy (also called "Extra Help") available under the Medicare Part D prescription drug program. It includes information on how one becomes eligible for the Low-Income Subsidy as well as useful outreach material.

Is extra help the same as Medicaid for seniors?

Extra Help eligibility

If you are enrolled in Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program (MSP), you automatically qualify for Extra Help regardless of whether you meet Extra Help's eligibility requirements.

What is the income limit for Medicare Part D Extra Help?

You live in one of the 50 states or the District of Columbia. Your annual income is below $22,590 for an individual, or $30,660 for a married couple. (Income limits are higher in Alaska and Hawaii.) Your resources are below $17,220 for an individual, or $34,360 for a married couple.

What is not covered by Medicaid?

Medicaid coverage can vary from state to state, but here are some common services and items that are typically not covered: Elective cosmetic procedures: Cosmetic surgeries and procedures, such as cosmetic dentistry and non-medical weight loss procedures, that are not medically necessary are typically not covered.

What is extra help in Medicaid?

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What happens if you make too much money while on Medicaid?

If you're over the Medicaid income limit, some states let you spend down extra income or place it in a trust to help you qualify for Medicaid. If you receive long-term care but your spouse doesn't, Medicaid will allow your spouse to keep enough income to avoid living in poverty.

How much can you make on social security and still get extra help?

You should contact Social Security for other resource exclusions. What is the income limit? To be eligible for Extra Help, your annual income must be limited to $22,590 for a person or $30,660 for a married couple living together.

How do I know if I get extra help with Medicare?

Call us at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. We can tell you your level of Extra Help and help you get your costs fixed with the plan.

Does everyone have to pay $170 a month for Medicare?

Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.

Who qualifies for an extra $144 added to their social security?

To qualify for a Medicare giveback benefit, you must be enrolled in Medicare Part A and B. You must be responsible for paying the Part B Premiums; you should not rely on state government or other local assistance for your Part B premiums.

What is the most popular Part D drug plan?

The best Medicare Part D provider is Aetna. It has top ratings from the Centers for Medicare & Medicaid Services and affordable premiums. Other great providers include Wellcare and UnitedHealthcare.

Does social security count as income for pace?

As a participating senior in a PACE program, any financial burden you may have is not directly dependent on your income from Social Security benefits or other sources. But it is dependent in an indirect way, because your eligibility for Medicaid depends on your income and resources.

What are the changes for extra help in 2024?

Starting January 1, 2024, you'll pay <up to $1.55 or $4.60 for generic drugs and up to $4.50 or $11.20 for brand-name drugs or $0> for each covered prescription you fill at one of your Medicare drug plan's participating pharmacies.

Is Medicare Part D mandatory?

Enrollment in Part D is generally voluntary, however, some people are required to be enrolled, and others should not enroll.

What is the out-of-pocket limit for Medicare Part D in 2024?

Whether you're taking only brand-name drugs or a mix of brand-name and generic drugs, most people who reach the catastrophic coverage phase in 2024 will pay between $3,300 and $3,800 in out-of-pocket costs. In 2024, Mr. Alvarez takes $200,000 in Medicare Part D covered brand-name drugs.

How much does extra help pay?

Medicare beneficiaries can qualify for Extra Help paying for their monthly premiums, annual deductibles, and co-payments related to Medicare prescription drug coverage. We estimate the Extra Help is worth about $5,300 per year for each beneficiary.

Do I have to reapply for Medicare extra help every year?

If you get Extra Help now, and meet the qualifications for next year, you'll get these cost savings automatically—you don't need to reapply. Even if you don't qualify for Extra Help now, you can reapply for Extra Help any time, if your income and resources change.

How do I get $144 added back to my Medicare?

To qualify for the giveback, you must:
  1. Be enrolled in Medicare Parts A and B.
  2. Pay your own premiums (if a state or local program is covering your premiums, you're not eligible).
  3. Live in a service area of a plan that offers a Part B giveback.

How do I get the $16728 Social Security bonus?

Specifically, a rumored $16,728 bonus that had people wondering if it was true or not in 2024? Sadly, there's no real “bonus” that retirees who receive Social Security can collect.

When my husband dies, do I get his Social Security and mine?

You cannot claim your deceased spouse's benefits in addition to your own retirement benefits. Social Security only will pay one—survivor or retirement.

Does Medicaid actually check your income?

Some states use a computerized system to cross reference a Medicaid applicant's reported income. For instance, in California, an electronic database, the Income Eligibility Verification System (IEVS), is used to match the income information provided by the applicant to other databases to verify it is accurate.

Why are people being kicked off Medicaid?

So, because states kept people on the Medicaid program for three years during the pandemic, there are a number of people who have had changes in circumstances, they have gotten new jobs, they have increased their hours at their existing jobs, and because of that increase in income, are no longer eligible.