My office fields many inquiries daily in helping our constituents to access beneficial government programs. One program our staff consistently gets questions on is the Medicare Low Income Subsidy/Extra Help Program. Some states previously referred to this as the Medicare Buy-In program.

In the past, the program’s application and available information was confusing to many older adults and individuals with disabilities. Some were led to believe they would need to change their primary healthcare provider or that it might take away their PACE prescription benefits. Nothing could be further from the truth. This program complements both your Medicare health coverage and PACE, and the only change to you will be more savings in your pocket.

Federal legislation mandated that the program’s application be simplified and the program be made uniform so that more individuals would be able to access it readily. Kathleen Burk, Medicare Outreach Coordinator of Allegheny County Department of Human Services and The Allegheny Link, was kind enough to share details with us on how the program works.

Depending upon income and assets, many older adults and people with disabilities can save money on their Medicare insurance premiums and co-payments. There are now two separate government programs that can help.

The Medicare Savings Program:

The Medicare Savings Program can cover the cost of the Part B premium, and possibly co-payments and deductibles, depending upon the applicant’s level of income. To qualify, an individual’s monthly income must be no greater than $1,218with resources no greater than $6,680. (For a married couple, the combined monthly income should be no greater than $1,639 with resources no greater than $10,020.)

The resources that are counted include money in the bank, stocks, bonds or other types of investment. The lower the amount of income and resources the applicant has, the greater the level of assistance available.

The “Extra Help” Program

“Extra Help” provides assistance with Medicare Part D prescription drug premiums and co-payments, and keeps people out of the coverage gap known as “the donut hole.”

In order to qualify, an individual’s income must be no greater than $1,353per month with resources no greater than $12,640. (For a married couple, the combined monthly income should be no greater than $1,821 with resources no greater than $25,620.)

For more information and to apply, you can contact Allegheny County Medicare Outreach Coordinator Kathleen Burk at 412-350-7079. We also have applications in my office and would be happy to assist you in this process. If there’s anything I can help you with, please contact my office at 412-621-3006 or visit my website at www.senatorferlo.com.