When You Need Extra Help
Some people with limited resources and income also may be able to get “Extra Help” to pay for the costs of a Medicare prescription drug plan, including monthly premiums, annual deductibles and prescription co-payments.
You automatically qualify and do not need to apply for Extra Help if you have Medicare and meet one of the following conditions:
- Have full Medicaid coverage
- Have Supplemental Security Income (SSI) or
- Participate in a state program that pays your Medicare premiums
If you have questions about “Extra Help,” call:
If you believe that your cost-sharing amount for any prescriptions is incorrect, TIHP can help you:
- Request help to obtain evidence of your proper copay level, or
- If you already have the evidence, to provide this evidence to us.
As a Part D plan sponsor, CMS regulations require us to have a process to help you determine if you are eligible for the Low Income Subsidy (LIS) when some of your documentation is missing or there is a conflict between the CMS system and your actual status.
Before you enroll, TIHP will tell you what your plan premium will be with a low-income subsidy.
TIHP accepts the following forms of evidence to establish the subsidy status of a full benefit dual eligible individual:
- Copy of valid State Medicaid card
- Copy of valid document from State Medicaid confirming active status
- Printed report from State Medicaid confirming active status
- Screen print from State Medicaid confirming active status
- Other material from State Medicaid confirming active status
These documents may be mailed to TIHP’s main office:
1908 N. Laurent Street, Suite 250, Victoria, TX 77901