If you're a Medicare beneficiary, you may qualify for programs that could save you money! Contact SHIINE to help you apply!
1. The Medicare Savings Programs
There are three different programs offered in South Dakota and the qualifications and benefits for each program vary.
What types of expenses are covered?
If you qualify, Medicare Savings Programs may cover some or all of these items:
Part A premiums (most people do not have a premium)
Part B premiums
How do I apply?
Visit your local Department of Social Services office.
When applying for Extra Help (Low Income Subsidy for Medicare Part D) your application will be sent to the Department of Social Services, where they will follow up with a mailing to gather more information to determine if you qualify for one of hte Medicare Savings Programs.
You can have either Original Medicare (Part A and B) or a Part C (Medicare Advantage Plan).
Medicare Savings Programs (Effective 2018)
Income less than:
Assets* less than:
$1,387 per month
$16,644 per year
*The Department of Social Services (DSS) does not count $1,500 above asset limits per person if it's set aside in a specific burial fund. Call your local DSS office to see what types of accounts qualify.
2. Extra Help program for savings with Medicare Part D
What is covered?
If you qualify, Extra Help may cover:
Donut hole/coverage gap (This is a temporary coverage gap where the plan you are in reduces the amount they pay for your prescriptions and you have to pay more. This coverage gap is being phased out due to the Affordable Care Act and will no longer exist in year 2020.)
Contact SHIINE if you need assistance with the fast and simple application process.
If you receive prescription coverage from an employer plan, you may not want to apply for this help. It could cause you to lose coverage through your employer health plan.
Extra Help for Part D (Effective 2018)
Income less than:
Assets less than:
Note: People with earned income or more individuals in their household may have higher income and still qualify for Extra Help!
Limited Income Newly Eligible Transition Program (LI NET)
Medicare's LI NET program provides immediate prescription drug coverage for people with Medicare who are at the pharmacy counter and qualify for Extra Help, but aren't enrolled in a Medicare Prescription Drug Plan. Medicare's LI NET program covers all Part D covered drugs, and there are no network pharmacy restrictions during the time period covered by this program. The person will be charged the reduced co-payment based on the level of Extra Help they get.
Medicare's LI NET program also covers prescriptions that eligible people filled within the last 30 days.
For more information on getting your prescriptions filled at a pharmacy using the LI NET program, contact your local DSS office.