Some people with limited resources and income also may be able to get “Extra Help” to pay for the costs of a Medicare prescription drug plan, including monthly premiums, annual deductibles and prescription co-payments.
You automatically qualify and do not need to apply for Extra Help if you have Medicare and meet one of the following conditions
Have full Medicaid coverage
Have Supplemental Security Income (SSI)
Participate in a state program that pays your Medicare premiums
The Social Security Office at 1-800-772-1213, between 8 am to 7 pm, Monday – Friday. TTY users should call 1-800-325-0778
Your state Medicaid Office
If you believe that your cost-sharing amount for any prescriptions is incorrect, Provider Partners Health Plans can help you
Request help to obtain evidence of your proper copay level.
By submitting the existing evidence to Medicare on your behalf.
As a Part D plan sponsor, CMS regulations require us to have a process to help you determine if you are eligible for the Low Income Subsidy (LIS) when some of your documentation is missing or there is a conflict between the CMS system and your actual status.
Before you enroll, Provider Partners Health Plans will tell you what your plan premium will be with a low-income subsidy.
Provider Partners Health Plans accepts the following forms of evidence to establish the subsidy status of a beneficiary that is institutionalized and qualifies for zero cost-sharing
Documentation from the facility showing Medicaid payments for a full calendar month
Documentation from the state that confirms Medicaid payment to the facility for a full calendar month
A screen print from State Medicaid showing the institutional status based on a full calendar month stay for Medicaid payment purposes
Provider Partners Health Plans accepts the following forms of evidence to establish the subsidy status of a dual eligible individual
A copy of valid State Medicaid Card showing eligibility dates
Complete documentation of contact with State Medicaid verifying the Medicaid status (including date and time of contact, name, title, and phone number of the person contacted)
Documentation that confirms active Medicaid status
A printout from the State electronic enrollment file showing Medicaid status
A screen print from the State’s Medicaid systems showing Medicaid status
Other documentation provided by the State showing Medicaid status
These documents may be mailed to Provider Partners Health Plans’ main office
Provider Partners Health PlansPO Box 21063Eagan, MN 55121
Still have questions?
Our team is standing by to help make your prescriptions payments easy.
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