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Do You Need Help Paying for Medicare Coverage? (SHIIP Programs)

If you are on Medicare and have limited income and assets, you may qualify for assistance with paying for some of your medical expenses through the Extra Help and Medicare Savings Programs, but you have to apply.

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Extra Help

The Extra Help Program – or Low Income Subsidy (LIS) – helps qualified Medicare beneficiaries pay for their prescription drug program costs, such as premiums, deductibles and coinsurance. Eligibility guidelines are based on income and assets, and they change from year to year.

Any level of assistance provides:

  • Elimination of the Part D coverage gap (donut hole)
  • Opportunity to change Prescription Drug Plans at any time
  • Reduced Part D deductible and copay
  • Reduced cost of prescription drugs
  • Elimination of the Late Enrollment Penalty, if you haven’t already signed up for a Part D Plan when you apply for LIS

People who qualify for full Extra Help/LIS assistance also receive these benefits:

  • No Part D premium, based on plan selection
  • No Part D deductible
  • The lowest Part D copays

Medicare Savings Programs

The Medicare Savings Programs (MSPs) help qualified Medicare beneficiaries pay for their Medicare health care costs, such as:

  • Medicare premiums
  • Coverage for Parts A and B deductibles and coinsurance
  • Prescription drug costs

There are different levels of assistance through Medicare Savings Programs. Even if you don’t quality for full assistance (Full Medicaid), you might be eligible for help with some of your medical expenses. Eligibility guidelines are based on income and assets, and they change from year to year.

For More Information

For more information or help completing an application, contact the NC Seniors’ Health Insurance Information Program (SHIIP) at 855-408-1212, or call one of the Wake County SHIIP counseling sites listed below and ask for SHIIP help.

Cary Senior Center, 919-469-4081 Northern Wake Senior Center, 919-554-4111

Eastern Wake Senior Center, 919-365-4248 Anne Gordon Center, 919-996-4720

Garner Senior Center, 919-661-6894 Five Points Center, 919-996-4730

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