Celebrate Medicare’s Anniversary With Greater Access to “Extra Help” With Prescription Costs
Reading Time: 2 MinutesLast Updated: July 30, 2024
On July 30, 1965, President Lyndon B. Johnson signed landmark legislation that created Medicare and Medicaid. At his side was former President Harry Truman, a champion of national health insurance.
Medicare is a federal health insurance program for people 65 and older and people with disabilities and kidney disease. Medicaid is health coverage for people who have low incomes.
From the beginning, Medicare provided health insurance to nearly all Americans ages 65 and older who received Social Security or railroad retirement benefits. “Original” Medicare had Part A (Hospital Insurance) and Part B (Medical Insurance).
Medicare has changed as the needs of Americans have changed. In 1972, the program was expanded to cover:
- People receiving Social Security disability benefits for at least 24 months.
- People with End-Stage Renal Disease (ESRD) who need dialysis or a kidney transplant.
Prescription drug coverage added in 2003
The biggest changes in Medicare came about more than 20 years ago with the Medicare Prescription Drug Improvement and Modernization Act (MMA). This 2003 law created Part D, a prescription drug benefit. Coverage is optional for anyone with Medicare who enrolls in a private plan.
The law also created the Extra Help program that provided full and partial subsidies for people with limited resources and income to help them pay for prescriptions. The greater their financial need, the greater their subsidy.
More Medicare beneficiaries can now get help
As of January 2024, more people can get Extra Help with Medicare prescription coverage.
A new law ended partial subsidies, increased resource and income limits, and expanded savings.
Medicare beneficiaries who have Extra Help pay:
- $0 premiums.
- $0 deductibles.
- No more than $4.50 for generic drugs.
- No more than $11.20 for brand-name drugs.
- $0 for each covered drug once total drug costs reach $8,000 in a year.
How to apply for Extra Help
In most cases, you must have resources and income below a certain limit to get Extra Help. These limits may change every year. Also, you must live in the United States. Some people automatically get Extra Help and don’t need to apply. They include people with Medicaid and people with Medicare who receive Supplemental Security Income (SSI).
If you or someone you know may be eligible for Extra Help, the easiest way to apply is with our online application. For more information, visit Help with drug costs.
To learn more about Medicare, read our publication or visit Medicare.gov.
Please share this with family, friends, and others in your community who may need it.
Did you find this Information helpful?
Tags: Medicaid, Medicare, online services
See CommentsAbout the Author
Comments
Leave a Comment
Please review our Comment Policy before leaving a comment. For your safety, please do not post Personally Identifiable Information (such as your Social Security Number, address, phone number, email address, bank account number, or birthdate) on our blog.
Quacy M.
i practically own these locations for using my medicare,medicaid and social security Brookdale University Hospital and Medical Center Brooklyn New York city 11212. And Kings County Hospital Center Brooklyn New York city 11203. bankrupt them with my money and demolish them with my money they used from medicare,medicaid and social security. don’t put them back up
Otchere A.
I presently live outside of USA and I pay for medicare but don’t have access to medicare. When I get sick I spend so much on medical bills on my small social security money.
Sal M.
Many Medicare Advantage plans allow you to obtain emergency care or urgent care abroad if you first pay for treatment upfront. You then need to submit the receipt to your plan for reimbursement up to a predetermined limit (depending on the company).
Dee T.
Why do you pay for it and not have access to it?
S.D.
Hi, Otchere. Thanks for reading our blog and for your comments. Medicare usually doesn’t cover health care outside the U.S., with some exceptions. To learn more, check out the Medicare Coverage Outside the United States factsheet. We hope this helps.
BARKAT J.
Had Medicare and Medicaid disappeared, the money from old people would have gone to doctors and hospitals. They would be indebted and homeless.
Paula C.
The same has happened to me and lost my Humana because of Medicaid
GLADYS I.
My mother is 98 years old and has dementia. She will not use a computer. Who do I see or talk to about being able to access her SS information?
Dee T.
Sign up with Social Security to be her Payee. You will have access to everything she has
S.D.
Hi, Gladys. Thanks for reading our blog and for your question. You may apply to become your mother’s representative payee so that you can manage her benefits. For more information about becoming a payee, visit our Frequently Asked Questions. To make an appointment, you can call us at 1-800-772-1213, Monday through Friday, between 8:00 a.m. and 7:00 p.m., or contact your local Social Security office. You may also want to check out A Guide for Representative Payees so you understand your responsibilities as payee. We hope this helps.
John B.
The method of payment depending on your birthday in each month makes scheduling payments of expenses difficult. Can this somehow be changed to a specific day of each month?
The Defense Finance Agency manages to do it.
S.D.
Hi, John, and thanks for reading our blog and for your question. We’re sorry, but we can’t change your check date. For more information, visit our Frequently Asked Questions. We hope this helps.