Social Security Notice for Extra Help Review

If you’ve applied for and received “Extra Help” from Social Security, September is the month where some of you will be audited. Social Security doesn’t actually call it an audit, but it’s essentially the same thing; they select a group of people who had previously qualified for Extra Help and ask them to send in proof they still meet the thresholds.  If those people don’t respond within 30 days, they automatically lose the extra help.

What is Extra Help?

Some people with limited resources and income may be able to get Extra Help with the costs — monthly premiums, annual deductibles, and prescription co-payments — related to a Medicare prescription drug
plan. The Extra Help is estimated to be worth about $4,000 per year.  To find out if you qualify, you will have needed to apply for this – it’s not automatic in most cases.  The form is here.  You will have to do a bit of legwork and disclose personal financial situation such as how much money is in your checking and savings accounts, investments, real estate (other than your home), and your income. If you’re married, this information needs to be provided about your spouse as well as your habitation status.

How Do I Qualify?

To qualify for Extra Help, your resources must be limited to $13,640 for an individual or $27,250 for a married couple living together.
Resources include the value of the things you own. Some examples are:
• Real estate (other than your primary residence)
• Bank accounts including checking, savings and certificates of deposit
• Stocks
• Bonds, including U.S. Savings Bonds
• Mutual funds
• Individual Retirement Accounts (IRAs)
• Cash at home or anywhere else.

What Does Not Count As a Resource?

Social Security does not count:
• Your primary residence;
• Your personal possessions;
• Your vehicle(s);
• Resources you couldn’t easily convert to cash, such as jewelry or home furnishings;
• Property you need for self-support, such as rental property or land you use to grow produce for home consumption;
• Non-business property essential to your self-support;
• Life insurance policies;
• Burial expenses;
• Interest earned on money you plan to use for burial expenses; and
• Certain other money you are holding is not counted for nine months, such as:
—Retroactive Social Security or Supplemental Security
Income (SSI) payments;
—Housing assistance;
—Tax advances and refunds related to earned income tax credits and child tax credits;
—Compensation you receive as a crime victim; and
—Relocation assistance from a state or local government.

To qualify for Extra Help, your annual income must be less than $17,820 for an individual or $24,030 for a married couple living together. Even if your annual income is higher, you may still be able to get some help.

Extra Help Eligibility Review

In early September, Social Security sends out a form to a select bunch of folks to check and see if they still qualify for this extra help.  Watch your mailboxes, folks.  Interestingly, they do not have an online form.  You must use paper (scratches head).

When you get the form, you’ll have to complete it and send it in within 30 days or you will automatically lose your subsidy.  It’s essentially applying again as the information they’re asking for is essentially the same Social Security asked for when you originally applied.  Have your checking, savings, investments, etc. all ready to go – you’ll have to re-enter that information again on a paper form.  Then, you must sign and return the form in the envelope they provide you.  Remember… 30 days is all you get!

Be Prepared and Be Precise!

To prepare:
• Identify the things you own alone, with your spouse,
or with someone else, but do not include your home,
vehicles, burial plots, life insurance policies, or personal possessions;
• Review all your income; and
• Gather your records in advance to save time.

The records you’ll need are:
• Statements that show your account balances at banks,
credit unions, or other financial institutions;
• Investment statements;
• Stock certificates;
• Tax returns;
• Pension award letters; and
• Payroll slips.
The Social Security Agency won’t ask for proof to support the information you provide, but they will match your information with data
available from other government agencies to make sure it
is correct.

The Takeaway:

Watch your mailbox in early September if you get Extra Help.  If you do not return the form they send you within 30 days, your help with Medicare prescription drug plan costs will end. If for some reason you need more time, you get to wait on hold with the federal government, folks!  The only way to get a 30 day extension is by calling  Social Security at 1-800-772-1213 (TTY 1-800-325-0778).  Be prepared.  Have your statements ready, because if you misrepresent your resources, they will be cross-checking what you put down with “other data available.”  Be honest, and be on time!

The Three Types of Medicare Websites

Over the years, I’ve spent thousands of hours online reviewing Medicare websites.  What’s available is confusing, incomplete, wrong or not quite objective enough for me.   These websites fit neatly into three distinct categories.

1.  Insurance company websites

Insurance company websites can certainly be helpful, but looking for Medicare information at an insurance company website is much like doing new car research:  The Ford website will tell you everything you need to know about all the Ford options they have, but don’t/won’t tell you anything about Honda… or Chevy… or BMW… you get the point.  They don’t offer the complete picture or landscape of choices, but they usually do a pretty decent job of providing you company-specific information and the ability to enroll online.  Let’s be honest: the ability to enroll online may exist, but your patience will be taxed doing so.  Every insurance company website has a different way to enroll, different forms and different pages to navigate to.  The experience can be horribly frustrating, leading many people to simply either give up or call the company.  If you’re 100% sure you want to buy a policy from a particular policy, then enrolling online is the way to go.  If you want to compare different plans from different companies, you’ll have to visit multiple sites and each of them have their own web navigation positives and negatives.

2.  Lead-generation websites

Lead-generation websites are usually insurance agents or agencies that set up a site (or a dozen) to generate leads for themselves or their employees.  Often, these sites urge you to share your personal information, and then sell that information to a local agent or agency in your ear.  From what I’ve seen, they give you just enough information to get your interest piqued, then encourage you to contact them, send them your email address, etc.  They then either hound you to BUY BUY BUY or sell/give your information to call centers and/or insurance agents.  Their sites are full of long, complex definitions and articles chock-full of keywords the search engines love. They have to do this in order for Google, Bing or Yahoo to pay attention to them in hopes that when somebody searches for, “Medicare” their site ends up on the first page of the search results.  In all cases, unless you want to be contacted by someone trying to sell you something, stay away from these.

3.  Medicare’s Website

Medicare.gov is the Centers for Medicare and Medicaid (CMS) homepage.  Those are the folks who run (you guessed it!) Medicare and Medicaid.  If you’re ready to enroll in Medicare or you’re all set to enroll in a particular product, this is a good place to go but it’s not perfect by any stretch of the imagination.  However, there is a ton of content, and you could easily spend thousands of hours on their site reading through various items.  Information overload is easy to experience on this site, especially if you’re brand-new to Medicare.

The Takeaway

Learn to love medicare.gov.  The site does a decent job of helping you search for Medicare Advantage and PDP (Part D) plans, but is woefully lacking on helping you choose Medicare Supplemental plans.  Medicare.gov allows you to enter in your prescription drugs and pharmacy of choice.  Unfortunately, it doesn’t do a great job of letting you know your doctor or hospital of choice is in the plan’s network.  This is mostly due to the fact that Medicare PPO and HMO networks are in a state of constant flux; doctors and hospitals get added and removed on a monthly basis.   My advice is to use this site to enter in your prescriptions and pharmacy, and see what spits out.  Once you’ve narrowed down your top 3 choices, call those insurance companies and ask them if your doctors are in their plan.  They’ll try to sell you a policy over the phone.  Go ahead and buy it, if you’re ready, or do so online.

-OR-

Use a good independent Medicare insurance agent.  Note I said, “good” Medicare insurance agent, because they’re not all good and finding the good ones can be a chore.  Good agents will be able to narrow down the choices based on your financial goals, coverage needs, doctor usage and health status.  I’ve got a series of posts queued up on Medicare insurance agents, so check back soon!