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Help Paying for your Medicare Costs

How do I qualify?

Extra Help Paying for Medicare Prescription Drug Coverage (Part D)

Extra Help is a Medicare program to help people with limited income and resources pay Medicare prescription drug costs. You may qualify for Extra Help, also called the low-income subsidy (LIS) if your yearly income and resources are below the following limits in 2024:

  • Single person—Income less than $1,903 monthly and resources less than $17,220
  • Married person living with a spouse and no other dependents—Income less than $2,575 monthly and resources less than $34,360

These amounts may change each year. You may qualify even if you have a higher income (like if you still work, live in Alaska or Hawaii, or have dependants living with you). Resources include money in a checking or savings account, stocks, bonds, mutual funds, and Individual Retirement Accounts (IRAs). Resources don’t include your home, car, household items, burial plot, up to $1,500 for burial expenses (per person), or life insurance policies. If you qualify for Extra Help and join a Medicare drug plan, you will get the following:

  • Help paying your Medicare drug plan’s monthly premium, yearly deductible, coinsurance, and copayments
  • No coverage gap
  • No late enrollment penalty
  • You automatically qualify for Extra Help if you have Medicare and meet one of these conditions:
  • You have full Medicaid coverage
  • You get help from your state Medicaid program paying your Part B premiums (in a Medicare Savings Program)
  • You get Supplemental Security Income (SSI) benefits

Medicare Savings Program

Do you know there are money saving programs available to help Medicare beneficiaries? Listed below are three programs available in Indiana. If you have questions about eligibility or need assistance with filing an application, call SHIP at (800) 452-4800.

What can MSP pay for?

  • Part B Premium: $174.70
  • Part A Premium (If you have worked less than 10 years and must pay a premium)
  • Part B Deductible: $240
  • Part A Hospital Deductible: $1,632 per benefit period
  • Copayments for services (doctor, hospital, skilled nursing facility, etc.)

You may be eligible depending on your income and the value of things you own (2024):

   MONTHLY INCOMEASSETS
Qualified Medicare Beneficiary SINGLE $1,903 $9,430
COUPLES $2,575 $13,630
Specified Low Income Beneficiary SINGLE $2,154 $9,430
COUPLES $2,916 $14,130
Qualified Individual SINGLE $2,342 $9,430
COUPLES $3,172 $14,130

*$65 plus half your income from active employment does NOT count toward total income.
* Assets include resources such as checking and savings accounts, certificates of deposit, cash value of life insurance, stocks, and bonds. Some things you own do not count towards your asset limit, such as your home and furnishings, your car, burial plots, and at least $1,500 in life insurance. Annuitized retirement savings may not be included under certain circumstances.
** SLMB and QI only assist with Part B Premiums
***Approval for any of these programs makes you automatically eligible for Extra Help.

These limits are guidelines. The only way to know for sure if you are eligible is to apply.

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Need Help Applying?

Application Information

You may visit or call your local Office of Family and Children to apply for Medicare Buy-In.  You will need to complete an application form and participate in an interview.  The interview can take place in person or over the telephone.  Within 45 days, you will receive a notice in the mail that tells you whether your application was approved.

Click here for the application.

For more information about enrollment centers or Medicaid call:

  • A Local Enrollment Center:  call Indiana SHIP Office at (800) 452-4800 for locations
  • Your local Division of Family Resources office

Applications are processed by the Division of Family Resources

If your application is denied, you have the right to appeal within 30 days of the denial.  You may contact your local Area Agency on Aging or Senior Law Project for assistance with appeals.

Local Agency Contacts

View a complete list of agency contacts.

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Prescription Drug Plan Options

There are a variety of prescription drug plans to choose from.  These plans include:

  • Medicare Prescription Drug Plans
  • Hoosier Rx
  • Low Cost Drugs
  • Finding Help with Prescriptions Guide
  • Pharmaceutical Manufacturers Association Free Medications Directory

Standard Part D Benefit

Benefit Parameters2021202220232024
 Deductible $445 $480 $505 $545
 Initial Coverage Limit $4,130 $4,430 $4,660 $5,030
 Out-of-Pocket Threshold $6,550 $7,050 $7,400 $8.00
 Minimum Cost-Sharing in Catastrophic Coverage $3.70/$9.20 or 5% $3.95/$9.85 or 5% $4.15/$10.35 or 5% $4.50/$11.20 or 5%
LIS Copayments2021202220232024
 Institutionalized (with full Medicaid benefits) $0 $0 $0 $0
 Up to or at 100% FPL $1.30/$4.00 $1.35/$4.00 $1.45/$4.30 $1.55/$4.60
 Other LIS $3.70/$9.20 $3.95/$9.85 $4.15/$10.35 $4.50/$11.20

View a complete list of $0 Premium LIS Qualified Plans in Indiana for 2023

Medicare Prescription Drug Plans

People with Medicare can enroll in a Medicare prescription drug plan and receive extra help paying for the premiums, deductibles, gaps in coverage and co-pays. The 2024 resource limits are $1,903 ($2,575 if married) for the full low-income subsidy.

Hoosier Rx

Indiana's State Pharmaceutical Assistance Program, HoosierRx, can help pay the monthly Part D premium, up to $70 per month, for members enrolled in a Medicare Part D Plan working with HoosierRx.

To be eligible for HoosierRx, you must:

  1. be an Indiana resident, 65 years old or older.
  2. have a yearly income of $20,625 or less for a single person.
  3. have applied for the "Medicare Extra Help" through Social Security to pay for your Medicare Part D plan, and received either a "Notice of Award" or "Notice of Denial" from Social Security
    • Your Social Security "Notice of Denial" must be because your resources are above the limit established by law
    • Your Social Security "Notice of Award" must state that you are receiving partial extra help subsidy to help pay for your Medicare Part D premium

If you think you meet the eligibility requirements, please call a HoosierRx representative at 1-866-267-4679 or visit the HoosierRx website at https://www.in.gov/medicaid/members/194.htm.

VA Prescription Benefit

If you are an honorably discharged veteran, consider using your VA drug benefit ($8 per prescription per month).  Veteran can use the VA drug benefit by mail order for their monthly maintenance drugs and still use Medicare Part D for other prescriptions.  To apply, call 1-877-222-8387.

Low Cost Drugs

Several national pharmacies have announced they are drastically reducing the cost of generic prescription drugs. Meijer boasts no cost for generic antibiotics. Target, Wal-Mart and Sam's Club charge $4 for generic drugs, but the list includes more than antibiotics.

For a complete listing of what each pharmacy offers, log onto their respective Web sites

Pharmaceutical Manufacturers Association Free Medications Directory

Many pharmaceutical companies have programs which provide free or low cost medications to those in need regardless of age.

Most of these programs require that you:

  • Do not have insurance that covers outpatient prescription drugs
  • Do not qualify for government assistance
  • Have income within their stated guidelines

The application process is different for each company. Usually a doctor must sign your completed application form and have his/her office submit it for you. Rx for Indiana can provide assistance with matching your prescriptions with these assistance programs. Contact Rx for Indiana at 1-877-483-9275.

Visit the Rx for Indiana website.

Trained SHIP counselors at sites throughout Indiana can also guide you in getting and completing applications from drug companies.

Finding Help with Prescriptions Guide

"Finding Help with Prescriptions" Guide is a free publication. It provides helpful information for lowering your prescription costs including low-income assistance, patient assistance programs, mail order prescription services, veterans pharmacy benefits, and Community Health Centers.

To request a copy, call SHIP free of charge (800) 452-4800 or email SHIPHELP@idoi.in.gov.

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