Skip to main content
The Iowa Legal Aid Website (ILAW)
 
HOPE. DIGNITY. JUSTICE.
 
 
  Larger Text
 
 
 
   Tips on Searching

 
Find Legal Help On Health Care for Elders
Related Resources
Need Help With Medicare Expenses? Check Out the QMB and SLMB Programs
By: Legal Hotline for Older Iowans
Programs Help Pay Drug Costs
By: Legal Hotline for Older Iowans
Dealing With Medical Debt
By: Legal Hotline for Older Iowans
more...
Medicare Prescription Drug Coverage for People Who Get Medicaid
by: Iowa Legal Aid

Medicare provides prescription drug coverage for people who are eligible for Medicare alone, and for those who are eligible for both Medicare and Medicaid. "Dual eligibles" are the group of Medicare eligibles who also qualify for Medicaid. The following information is from Centers for Medicare & Medicaid Services (CMS), and is current as of January 3, 2010.

Prescription Drug Coverage: Basic Information

What is Medicare prescription drug coverage?
Medicare prescription drug coverage is insurance that covers both brand-name and generic prescription drugs at participating pharmacies in your area. Medicare prescription drug coverage provides protection for people who have very high drug costs or from unexpected prescription drug bills in the future.

Who can get Medicare prescription drug coverage?
Everyone with Medicare is eligible for this coverage, regardless of income and resources, health status, or current prescription expenses.

When can I get Medicare prescription drug coverage?
You may sign up when you first become eligible for Medicare (three months before the month you turn age 65 until three months after you turn age 65). If you get Medicare due to a disability, you can join from three months before to three months after your 25th month of cash disability payments. If you don't sign up when you are first eligible, you may pay a penalty. If you didn't join when you were first eligible, your next opportunity to join will be from November 15, 2010 to December 31, 2010.

How does Medicare prescription drug coverage work?
Your decision about Medicare prescription drug coverage depends on the kind of health care coverage you have now. There are two ways to get Medicare prescription drug coverage. You can join a Medicare prescription drug plan or you can join a Medicare Advantage Plan or other Medicare Health Plan that offers drug coverage.

Whatever plan you choose, Medicare drug coverage will help you by covering brand-name and generic drugs at pharmacies that are convenient for you.

Like other insurance, if you join, generally you will pay a monthly premium, which varies by plan, and a yearly deductible. You will also pay a part of the cost of your prescriptions, including a copayment or coinsurance. Costs will vary depending on which drug plan you choose. Some plans may offer more coverage and additional drugs for a higher monthly premium. If you have limited income and resources, and you qualify for extra help, you may not have to pay a premium or deductible. You can apply or get more information about the extra help by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or by visiting www.socialsecurity.gov on the web.


Why should I get Medicare prescription drug coverage?
Medicare prescription drug coverage provides greater peace of mind by protecting you from unexpected drug expenses. Even if you don't use a lot of prescription drugs now, you should still consider joining. As we age, most people need prescription drugs to stay healthy. For most people, joining now means protection from unexpected prescription drug bills in the future.

What if I have a limited income and resources?
There is extra help for people with limited income and resources. If you qualify for extra help, Medicare will pay for almost all of your prescription drug costs. You can apply or get more information about the extra help by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or visiting www.socialsecurity.gov on the web.

If your resources are less than $12,510 (single) or $25,010 (married) and your income is limited, you may qualify for extra help paying for Medicare Prescription Drug Coverage. These resource limits are for 2009 and may increase each year. The resource limits include things like your savings and stock. Resources do not include your home or car, life insurance policies, burial plot, and up to $1500 per person for burial expenses.. If you haven't received an application or information about the extra help, and you think you may qualify, you should apply. You can apply online by visiting the  Apply for Help with Medicare Prescription Drug Plan Costs section on the Social Security Administration website (www.ssa.gov).

Last Reviewed On: 01/08/10
 
 

READ THIS BEFORE USING ANY PART OF THE IOWA LEGAL AID WEBSITE (ILAW) If you cannot afford a lawyer and have a legal problem in Iowa, you may be able to get free legal help. Call Iowa Legal Aid. To find out which office serves your county, call 1-800-532-1275 or 515-243-2151 in the Des Moines calling area. If you are age 60 or over, you may be able to get free legal advice from The Legal Hotline for Older Iowans at 1-800-992-8161 or 282-8161 in Des Moines. All numbers are Voice and TTY.

This Website Does NOT Give Legal Advice. When you use ILAW, you are just making a request for information. No part of this site or any link found through this site is meant to give you legal advice. Using any part of this site does not make you a client. If you send an e-mail to anyone you reach through this site, it does not make you a client of any lawyer. See a lawyer to get complete, correct, and up-to-date legal advice.

ILAW Only Has a General Summary of the Law. It is not meant to fully explain topics. Do not assume what you read on ILAW applies to your specific case. Also, the law may vary from state to state. What you find on this website may not apply where you live or to court actions filed in other states.

The Law Often Changes. Content on this site was correct when it was written. Check the date on each page. Do not assume what you see here is still correct when you read it.

Links. This website has links to other Internet sites. We have these links so you can find help on legal matters from the justice community. Other sites are responsible for all content on their sites.

E-mail. Using ILAW or sending e-mail through this website does NOT make you a client of any person or program you reach through this site. When you use e-mail, you risk having someone else access part or all of your message.

Click here for the Iowa Legal Aid Internet Privacy Policy.

Click here for the Iowa Legal Aid Public and Client Complaint Procedures.

As You Look at this Website, Remember it is Not a Substitute for Legal Advice.

Powered by ProBono.Net

The Iowa Legal Aid Website is a project of Iowa Legal Aid, the Volunteer Lawyer Projects of the Iowa State Bar and Polk County Bar Associations, and HELP Legal Assistance

Comunity Legal Education booklets Iowa Legal Aid printed material is available to clients and the public. Click here for a publications order form.

Legal Services Corporation     Donate to Iowa Legal Aid     United Way