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Monthly Plan Premium for People who get Extra Help from Medicare to Help Pay for their Prescription Drug Costs
If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan.
This table shows you what your monthly plan premium will be if you get extra help.
Your |
Monthly |
Monthly |
Monthly |
Monthly |
100% |
$0.00 |
$26.10 |
$83.10 |
$169.10 |
75% |
$4.50 |
$35.10 |
$92.10 |
$178.10 |
50% |
$9.00 |
$44.00 |
$101.00 |
$187.00 |
25% |
$13.50 |
$53.00 |
$110.00 |
$196.00 |
*This does not include any Medicare Part B premium you may have to pay.
Plan premium includes coverage for both medical services and prescription drug coverage.
Do you Qualify for Extra Help?
To see if you qualify for Extra Help with your prescription drug costs, click the link below to visit the Social Security Administration's (SSAs) website. SSA’s website includes general information about LIS and the application itself. www.ssa.gov
If you aren’t getting extra help, you can see if you qualify by calling:
- 1-800-Medicare of TTY/TDD users call 1-877-486-2048 (24 hours a day/7 days a week),
- Your State Medicaid Office, or
- The Social Security Administration at 1-800-772-1213. TTY/TDD users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.
If you have any questions, please call Customer Services at 1-800-521-0265, TTY: 711 from 8 a.m. to 8 p.m. CST, 7 days a week.
Click here to view this information in a printable PDF format.
Best Avaliable Evidence
For additional information and forms related to the usage of Best Avaliable Evidence (BAE) for Part D plans, click on the link below to visit the Centers for Medicare and Medicaid Services' (CMS) website.
Updated 03/2012
H3044_WEB12_CMS_APPROVED_10112011
