Medicare FAQ

Can I get any of Medicare Part D's costs waived?

Low-income Medicare beneficiaries may qualify for a subsidy to help pay costs associated with Part D plans. This subsidy is called Extra Help. Also, under certain circumstances, the copayment for prescriptions may be waived or reduced.

You may qualify for a low-income Part D subsidy if:

  • you are eligible for Medicaid, or
  • your income is less than 150% of the federal poverty level (see Nolo's article on the federal poverty level) and your assets, not including your own home, are less than $13,640 ($27,250 for a married couple).

In addition to low-income subsidies, circumstances exist in which a Part D plan enrollee may not have to pay the normal copayment for a covered drug. These include:

  • People who live in a long-term care nursing facility, and who are enrolled in both Medicare Part D and Medicaid, have no copayments.
  • Some plans waive or reduce copayments for certain drugs, particularly generic versions, to coax people to join that particular plan. But the plan can change this copayment waiver at any time.
  • Pharmacies may waive copayments for any enrollee with a low-income subsidy, for any drug. But the waiver is not automatic; you have to ask for it.

Find out more in Nolo's article on Extra Help for Part D.

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