Medicare Extra Help | Allwell from Superior HealthPlan

Medicare's "Extra Help" Program

 

The Medicare Extra Help program is for anyone that has Medicare and Medicare Prescription Drug (Part D) coverage, but have limited income and resources such as savings and stocks. This does not include your home or car.

What does Medicare Extra Help cover?

The Extra Help program can save you up to $5,000 each year.  Many people qualify for this savings but don’t know it.

If you qualify for the Extra Help program, you will get help paying for Medicare prescription drug costs that is a part of your Part D coverage such as your monthly premium, yearly deductible, prescription co-payments and coinsurance. This Extra Help also counts toward your out-of-pocket costs.

See if You Qualify for Extra Help

Some people automatically qualify for the Extra Help program and don't need to apply. Medicare will mail you a letter if you automatically qualify for Extra Help.

Your income and resources can change from year to year, so check to see if you qualify for the program if you didn’t receive a letter from Medicare or were previously denied for the Extra Help program.

Please select the document for your plan and county:

For HMO Members:

Plan Name CMS# County Low Income Subsidy
Allwell Medicare (HMO) H0062-001

Aransas, Bexar, Comal, El Paso, Guadalupe, Jim Wells, Nueces and Wilson counties
Allwell Medicare (HMO) H0062-002

Collin, Dallas, Denton, Rockwall and Tarrant counties
Allwell Medicare (HMO) H0062-003

Cameron, Hidalgo and Starr counties
Allwell Medicare (HMO)
 H0062 - 009 Fort Bend and Montgomery counties

For HMO SNP Members:  

Plan Name CMS# County  Low Income Subsidy
Allwell Dual Medicare
(HMO D-SNP)		 H5294-002-002

Cameron, Hidalgo and Starr counties
Allwell Dual Medicare
(HMO D-SNP)		 H5294-002-003

Collin, Dallas, Denton, Rockwall and Tarrant counties
Allwell Dual Medicare
(HMO D-SNP)		 H5294-002-004

Aransas, Bexar, Comal, El Paso, Guadalupe, Jim Wells, Nueces and Wilson counties
Allwell Dual Medicare
(HMO D-SNP)
 H5294-007
 Fort Bend and Montgomery counties
Allwell Dual Medicare
(HMO D-SNP)
 H5294-009
 Lubbock

Apply for Extra Help

Applying for Extra Help is easy. Just complete the Social Security’s application for the Medicare Extra Help program in the following ways.

After you apply, you will get a letter letting you know if you qualify for Extra Help and what you need to do next.

Level of Extra Help (Low Income Subsidy)

Your total monthly plan premium, copays, and deductibles may vary based on the level of Extra Help you receive.

The Low Income Subsidy (LIS) table shows you what your monthly plan premium will be if you get Extra Help.

Please select the document for your plan and county.  If you have questions, call Member Services. We’re here to help.

Please select the document for your plan and county:

For HMO Members:

Plan Name  CMS# County Low Income Subsidy
Allwell Medicare (HMO) H9630-001 Benton, Carroll, Clay, Cleburne, Crawford, Cross, Franklin, Fulton, Independence, Izard, Jackson, Johnson, Lawrence, Logan, Madison, Mississippi, Newton, Perry, Poinsett, Prairie, Randolph, Scott, Searcy, Sebastian, Sharp, Stone, Van Buren, Washington, White, Woodruff and Yell
  • Low Income Subsidy, H9630-001 - English (PDF)

  • Low Income Subsidy, H9630-001 - Spanish (PDF)
Allwell Medicare (HMO) H9630-002 Clark, Conway, Craighead, Faulkner, Garland, Greene, Hot Spring, Lonoke, Pope, Pulaski and Saline
  • Low Income Subsidy, H9630-002 - English (PDF)
Allwell Medicare Premier (HMO) H9630-003 Benton and Washington
  • Low Income Subsidy, H9630-003 - English (PDF)

  • Low Income Subsidy, H9630-003 - Spanish (PDF)
Allwell Medicare (HMO) H9630-004

 Baxter, Boone, Marion
  • Low Income Subsidy, H9630-004 - English (PDF)
Allwell Medicare Premier (HMO) H9630-005

 Baxter, Boone, Marion
  • Low Income Subsidy, H9630-005 - English (PDF)
Allwell Medicare Premier (HMO) H9630-006 Benton, Carroll, Clay, Cleburne, Crawford, Cross, Franklin, Fulton, Independence, Izard, Jackson, Johnson, Lawrence, Logan, Madison, Mississippi, Newton, Perry, Poinsett, Prairie, Randolph, Scott, Searcy, Sebastian, Sharp, Stone, Van Buren, Washington, White, Woodruff, Yell.
  • Low Income Subsidy, H9630-006 - English (PDF)

If you have questions please, contact Member Services.

If you have questions please, contact Member Services.