HELP WITH PRESCRIPTION DRUG COSTS
Q: I take a benzodiazepine to help me sleep. My pharmacist just told me my Medicare drug plan no longer covers this drug. Why would my plan stop paying for this drug? I told my pharmacist I can’t afford to pay for the drug. He told me to apply for “Extra Help.” What is this “Extra Help” program and how do I apply?
A: Benzodiazepines are one of several drugs Medicare doesn’t require drug plans to cover. Drug plans that cover benzodiazepines will often charge higher annual premiums because they provide this extra benefit. Perhaps your drug plan decided to drop the benzodiazepine benefit to either lower its premiums or avoid increasing its premiums.
“Extra Help” is a low-income subsidy program for Medicare recipients. It helps with prescription drug premiums, deductibles and co-payments. If you are single with an annual income less than $16,245 and resources less than $12,510, or if you are married with a combined annual income less than $21,855 and combined resources less than $25,010, you might qualify for this benefit.
Unfortunately, the “Extra Help” program will not assist with your benzodiazepine costs because this program only helps with drugs covered by a Medicare recipient’s drug plan. However, it might still save you money by helping you with premiums, deductibles and other drug co-pays should you qualify for the program. Ask your doctor if there is another drug covered by your plan that might help you sleep instead of benzodiazepines, which are covered by only a few Medicare drug plans.
You can apply for “Extra Help” by calling the Social Security Administration at (800)772-1213. Don’t assume your resources will disqualify you for this benefit. A number of assets, such as the home you live in, are not considered resources when determining your eligibility for “Extra Help.”
Sources: Your Guide to Medicare Prescription Drug Coverage, a free publication of the Centers for Medicare and Medicaid Services.
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