Extra Help From Medicare

 

2025 Medicare Extra Help/LIS income and resource limits

You can qualify if you are eligible for Medicaid as well as Medicare. You also may qualify if your yearly income is $22,590 or less if you are single with no dependents, or $30,660 or less if you are married and living with your spouse with no dependents, and your resources are less than $17,220 if single or $34,360 if you are married and living with your spouse. If you live in Alaska or Hawaii, or pay at least half of the living expenses of dependent family members, income limits are higher.

For additional information on copays and premiums for those who qualify for Extra Help from Medicare, please contact Capital Health Plan Medicare Sales at 850-523-7441 or 1-877-247-6512.

To see if you qualify for Extra Help, call:

  • 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7days a week.
  • Social Security at 1-800-772-1213, between 8:00 a.m. and 7:00 p.m. local time, Monday through Friday. TTY users should call 1-800-325-0778; or
  • Your State Medicaid Office
  • Extra Help: Medicare.gov
  • Best Available Evidence

If you believe you have qualified for Extra Help and you feel you are paying an incorrect cost-sharing amount when you get your prescription at a pharmacy, our plan has established a process that allows you to either request assistance in obtaining evidence of your proper copayment level, or to provide this evidence to us if you already have it. For additional information, please contact Capital Health Plan Member Services or see the link above for "Best Available Evidence."