Medicare Plans - Help

Learn About How to Get Extra Help

Extra Help for your prescription drug costs

Medicare eligible beneficiaries with limited income and resources may qualify to get extra help for their prescription drug costs.  If you qualify, Medicare could help you pay for your monthly prescription drug premium, annual deductible, copayments and coinsurance.  The amount of extra help varies based on your income and resources.

Millions of people receive Extra Help for their prescription drug costs, so why not find out if you qualify?  Even if you’re not sure that you qualify, go ahead and apply.  There’s no risk and no cost, so you might as well try!

The Social Security Administration is accepting applications by mail and on their Website.

HealthSun Health Plans 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 does not include any Medicare Part B Premium you may have to pay.  You must continue to pay your Medicare Part B premium.

This table shows you what your monthly plan premium will be if you get extra help in 2018:

Your level of extra help Monthly Premium for 001 HealthSun SunPlus Advantage Plan (HMO)* Monthly Premium for 006 HealthSun MediMax (HMO)* Monthly Premium for 012 HealthSun HealthAdvantage Plan (HMO)*
100% $0 $0 $0
75% $0 $7.30 $0
50% $0 $14.50 $0
25% $0 $21.80 $0

This table shows you what your monthly plan premium will be if you get extra help in 2017:

Your level of extra help Monthly Premium for 001 HealthSun SunPlus Advantage Plan (HMO)* Monthly Premium for 006 HealthSun MediMax (HMO)* Monthly Premium for 012 HealthSun HealthAdvantage Plan (HMO)*
100% $0 $0 $0
75% $0 $7.30 $0
50% $0 $14.50 $0
25% $0 $21.80 $0

 

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

HealthSun Health Plans’ premium includes coverage for both medical services and prescription drug coverage.

If you aren’t getting extra help, you can see if you qualify by calling:

  • 1-800-Medicare of TTY 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 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 Member Service at 1-877-336-2069 (TTY: 877-206-0500) from 8:00 a.m. to 8:00 p.m. EST, Monday through Friday. During October 1 to February 14, we are open 7 days a week from 8:00 a.m. to 8:00 p.m. EST.  From February 15 to September 30, we resume Monday through Friday. 

HealthSun Health Plans is an HMO plan with a Medicare contract.  Enrollment in HealthSun Health Plans depends on contract renewal.  This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premium and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. HealthSun complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.  ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.  Llame al 1-877-336-2069. (TTY: 1-877-206-0500).  ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-877-336-2069. (TTY: 1-877-206-0500). 

   

 

More about Extra Help (LIS)

Extra Help is also known as the Low Income Subsidy (LIS).  The LIS program is for Medicare beneficiaries with limited income and resources to help them pay for their prescription drug costs including monthly premiums, annual deductibles, and copayments.  Many Medicare beneficiaries are eligible for these savings and don’t know it.  Those who qualify will enjoy free drug coverage or reduced costs on their Part D benefits. 

For more information about Extra Help, contact your local Social Security office or call 1-800-Medicare (1-800-633-4227) 24 hours a day, seven days a week.  TTY 1-877-486-2048.  You can also contact your state Medicaid office through the Department of Children and Families at 1-866-762-2237.  TTY 1-800-955-8771 or 1-800-955-8770.  Visit www.myflorida.com/accessflorida on the web. 

Some Medicare beneficiaries qualify automatically for Extra Help because they also have other programs such as Medicaid, Medicare Savings Programs, and Social Security Income (SSI) benefits.  While others need to apply.

How do I apply?

The simple, four-page application is available at your local Social Security Administration office.  Call 1-800-772-1213, 7 a.m. to 7 p.m., Monday through Friday. TTY 1-800-325-0778.  You can also apply online for extra help by visiting www.ssa.gov for “Extra Help With Medicare Prescription Drug Plan Costs”.  You will need to answer some questions about your assets and sources of income.  The application is secured, which means only you and the Social Security Administration can see the information you provide.  You should review your application before you submit and print your receipt. 

Remember, applying for extra help is NOT the same as joining a prescription drug plan.  Whether you qualify for extra help or not, you must also enroll in a plan to get prescription drug coverage.

Enrollment Information

Please remember that if you are already enrolled in one of the HealthSun benefit plans then you should not enroll in a stand-alone Part D Plan (PDP) because your HealthSun plan already includes a prescription drug plan.  Enrollment into a PDP plan will automatically disenroll you from HealthSun.  Click here to see how you can enroll with HealthSun Health Plans, or to find other information on enrollment/disenrollment. 

 

Make sure the plan you choose covers the drugs you take – Explore which drugs each plan covers.  Click here to see information on our Prescription Drug Benefits.   

Help Resources

Centers for Medicare & Medicaid Services

Website: www.medicare.gov
Toll-free: 1-800-Medicare (1-800-633-4227)
TTY: 1-877-486-2048
24 hours a day, seven days a week

 

Social Security Administration

Website: www.ssa.gov
Toll-free: 1-800-772-1213
TTY: 1-800-325-0778
7 a.m. to 7 p.m., Monday through Friday