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Extra Help Paying for Prescriptions

Get help paying for your Medicare prescription drug costs 

The Extra Help program is for those with limited income and resources. It helps pay for Medicare prescription drug costs. If you qualify for Extra Help, you’ll: 

  • Get help paying your Medicare drug plan’s monthly premium, yearly deductible, coinsurance, and copayments
  • Have no coverage gap
  • Have no late enrollment penalty
  • Have the chance to switch plans at any time

Premium for Aetna members with Extra Help

You pay a lower plan premium if you qualify for Extra Help. The level of Extra Help you get determines your monthly plan premium. 

For 2017

You may qualify if you have up to $17,820 in yearly income ($24,030 for a married couple) and up to $13,640 in resources ($27,250 for a married couple).

Choose your location and plan to see your 2017 monthly plan premium:

* State
* County
* Plan

For 2016

In 2016, you may qualify if you have up to $17,820 in yearly income ($24,030 for a married couple) and up to $13,640 in resources ($27,250 for a married couple).

Choose your location and plan to see your 2016 monthly plan premium:

* State
* County
* Plan

How to apply for Extra Help 

Apply online

Or call Social Security at 1-800-772-1213 or TTY: 1-800-325-0778, Monday through Friday, 7 a.m. to 7 p.m.

Aetna members can receive help applying for Extra Help. To get help with your application, call "My Advocate" at 1-866-706-6757 (TTY: 711). They’re available Monday through Friday, 9 a.m. to 6 p.m. ET. "My Advocate" is a service offered by an independent company.

Learn more about Extra Help 

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. 

See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premium and/or copayments/coinsurance may change on January 1 of each year.

Our dual-eligible Special Needs Plan is available to anyone who has both Medical Assistance from the state and Medicare. Premiums, copays, coinsurance and deductibles may vary based on the level of Extra Help that you receive. Please contact the plan for further details. 

You must continue to pay your Medicare Part B premium. 

The Part B premium is covered for full-dual members (those who have both Medicare and Medicaid, and meet the state’s requirements for full Medicaid benefits).  

The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. 

Aetna Medicare’s pharmacy network offers limited access to pharmacies with preferred cost sharing in: Suburban NY and TX; and Rural ME, NY, UT and WY. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, members please call the number on your ID card, non-members please call 1-855-338-7027 (TTY: 711) or consult the online pharmacy directory at http://www.aetnamedicare.com/pharmacyhelp.

Members who get “Extra Help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays.  

       Y0001_4006_8294 Approved 11/04/2016

       Page last updated: Oct 20, 2016

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