The US Department of Health and Human Services is announcing new tools to lower prescription drug costs for low-income people with Medicare through the Extra Help program, which provides eligible seniors and disabled people with help paying for their Medicare Part D premiums and cost-sharing. These resources complement forthcoming expansions in Extra Help benefits and will ensure more people eligible for benefits are enrolled in this program.
Beginning January 1, 2024, eligible seniors and people with disabilities will benefit even more through the expansion of the Extra Help program. Nearly 300,000 low-income people with Medicare currently enrolled in the Extra Help program stand to benefit from the program’s expansion.1 People with Extra Help currently with partial benefits who will be newly eligible for full benefits will pay no deductible, no premium, fixed lower copayments for certain medications, and could save nearly $300 per year, on average, according to estimates .
Up to 3 million seniors and people with disabilities could benefit from the Extra Help program now but aren’t currently enrolled. The expansion of the Extra Help program provides an important opportunity to those who could benefit from the program’s lower cost premiums, deductibles, and copayments—now and when the program expands in 2024.
The Department of Health and Human Services (HHS), through the Administration for Community Living (ACL) and the Centers for Medicare & Medicaid Services (CMS), is announcing actions to reach eligible seniors and people with disabilities and improve enrollment in Extra Help as follows:
- ACL is announcing targeted efforts, informed by a comprehensive equity analysis, to reach, screen, and enroll people in the Extra Help program, specifically focused on Americans living in rural and underserved communities. These efforts will leverage data made available by CMS and involve ongoing technical assistance to grantees in the Medicare Improvement for Patients and Providers Act (MIPPA) program, the State Health Insurance Assistance Program (SHIP) , and other ACL grantees working with communities.
- CMS is releasing new national data on people with Medicare Part D prescription drug coverage living in the community who currently benefit from Extra Help, those who are expected to save more on prescription drug costs thanks to the program’s expansion in 2024, and those who are likely eligible for Extra Help but not enrolled. This data set includes key demographic information like age, gender, race and ethnicity, marital status, living alone, metro status, limited English proficiency, disability status, and other community characteristics.
- CMS is making available an outreach toolkit for beneficiary advocates and community-based organizations to raise awareness of the Extra Help program’s benefits and how to enroll, including social media content and a consumer-friendly article, and will encourage drug plans to assist eligible individuals in enrolling in Extra Help.
- In addition, CMS will continue to:
- Educate partners and advocates through the National Medicare Education Program.
- Train SHIP counselors, agents, and brokers through annual Open Enrollment training.
- Include information on Extra Help in the Medicare & You handbook, which is sent each year to more than 60 million people with Medicare.
- Remind people with Medicare about Extra Help through emails and social media.
- Train 1-800-MEDICARE call center representatives to provide callers information on Extra Help.
More information is available in the full announcement from US HHS here.