Low Income Subsidy Benefit Overview

The following information is for the 2009 plan year. For information on the 2008 plan year, click here.

If you have limited income and resources, Social Security may help you pay for your drug coverage.

Do You Need to Apply?

Some people will receive assistance automatically and do not need to apply. If you answer yes to any of the questions below, you automatically qualify for extra help and do not need to apply to Social Security:

• Do you have Medicare and full coverage from a state Medicaid program that currently pays for your prescriptions?
• Do you get Supplemental Security Income?
• Do you get help paying your Medicare premiums from your state Medicaid program (belong to a Medicare Savings Program)?

Should You Apply?

Click here to find out if you should apply for extra help with your prescription drugs.

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower. The amount of extra help you get will determine your total monthly plan premium as a member of our plan.

This table demonstrates what your monthly plan premium for 2009 will be if you get extra help.

*This does not include any Medicare Part B premium you may have to pay.

For more information on receiving Federal Extra Help:

• Apply at your local State Medical Assistance office.
• Call the Social Security Administration at 1-800-772-1213 (TTY/TDD 1-800-325-0778), M-F, 7 a.m. until 7 p.m. EST or visit the Social Security Web site.
• Call 1-800-MEDICARE (1-800-633-4227).  TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week

You might also qualify for extra help from your State:

• Maryland has the Senior Prescription Drug Assistance Program (SPDAP), which provides up to a $25 monthly premium subsidy and up to a $1200 coverage gap subsidy to eligible Maryland residents.
  • Call 1-800-551-5995 (9 a.m. - 5 p.m. EST, weekdays) TTY/TDD 1-800-877-5156 for more information about the Maryland SPDAP.
  • Please note that Medi-CareFirst participates in the Premium and Coverage Gap Subsidy Programs offered by Maryland SPDAP.
• Delaware has two extra help programs for Delaware residents:
  • The Delaware Prescription Drug Assistance Program provides assistance with premiums and other benefit related costs — up to $2500 in assistance provided per year. Call 1-800-996-9969, and select option 2, then option 1.
  • The Delaware Chronic Renal Disease Program covers Part D deductibles, copays, and premiums. Call 1-800-996-9969, and select option 2, then option 1.
• The District of Columbia has no State Prescription Drug Assistance Program.

Note: Please visit the CMS website for the most up-to-date changes on low-income subsidy rules. These are called "best available evidence" (BAE) policies, and can be found in the BAE section of the CMS Part D website.