Extra help with plan premiums

You may be able to get extra help to pay for your prescription drug premiums and costs.

How much assistance can you receive?

• 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.
• Priority Health Medicare Advantage plan premiums include coverage for both medical services and prescription drug coverage.
• Once you enroll in one of our plans, Medicare will tell us how much assistance you are receiving. We will send you information on the amount you will pay.
• The premiums listed in the table below do not include any monthly Medicare Part B premium you may have to pay.

How to find out if you qualify for getting extra help

If you automatically qualify for premium assistance, you don't have to apply. You automatically qualify for this assistance if you're eligible for Medicaid, Supplemental Security Income (SSI), or a Medicare savings program. You may receive (or may have received) a letter from Medicare or the Social Security Administration (SSA) about your eligibility for 2010. Read this important information carefully.

If you have not received a letter but you think you may qualify for extra help, call:

• 1-800 MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week.
• The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778.
• Your State Medicaid Office

How to prove you need more help

If you think you qualify for a higher subsidy than you are receiving, it is helpful to have one or more of these documents with you when you ask us for more help. We are required to accept any of the following forms of evidence to help establish your subsidy level. These documents can be provided by you or by your pharmacist, advocate, representative, or family member.

• A copy of the beneficiary’s Medicaid card that includes the beneficiary’s name and an eligibility date during a month after June of the previous calendar year
• A copy of a state document that confirms active Medicaid status during a month after June of the previous calendar year
• A print out from the State electronic enrollment file showing Medicaid status during a month after June of the previous calendar year
• A screen print from the State’s Medicaid systems showing Medicaid status during a month after June of the previous calendar year
• Other documentation provided by the State showing Medicaid status during a month after June of the previous calendar year
• For individuals who are not deemed eligible, but who apply and are found LIS eligible, a copy of the SSA award letter.

For more information, see the policies on the Best Available Evidence at the Centers for Medicare and Medicaid Services website by clicking the link below. Note: This link will take you away from the Priority Health Medicare website.
Read the "Best Available Evidence" policy on the CMS website now.