Do you get Medicare? Do you also get Medicaid benefits?
If you answered yes to both of these questions, you will be automatically enrolled in the Medicare drug benefit program. You are considered a "dual eligible." This means that you are eligible for both Medicare and Medicaid. Dual eligible people do not need to enroll in the low-income subsidy—it will automatically be done for you.
Do you only receive Medicare?
If you only receive Medicare and not Medicaid or MQB, you will have to file TWO different applications to be eligible for the full benefits of the new Medicare drug benefit program. You have until May 15, 2006 to file the applications.
The first application is so you can be enrolled in a Prescription Drug Plan. This application is done directly through the individual drug companies. You can call 1-800-MEDICARE to determine which Prescription Drug Plan is best for you.
The second application is to check your financial information to see if you are eligible for a subsidy to help you pay for your medications. There are two types of subsidies available and they depend on the amount of your income and resources:
If your income is below $12,924 for an individual (with resources less than $6,000) and $17,328 for a couple (with resources less than $9,000), then you are eligible for the full subsidy. You will not have any premiums to pay or deductibles to meet. You will still have to pay a co-pay to get your prescriptions.
If you are an individual and your income is between $12,924 and $14,363.88 (with resources less than $10,000) or you are a couple with income between $17,328 and $19,247.88 (with resources less than $20,000), then you are eligible for the other low-income subsidy. You will have an annual deductible of $50 and you will get a subsidy of up to 75% of the amount of your premium. You will also have a co-pay to get your prescriptions.
You can get the application for the subsidy through your local Social Security Office or your local Department of Social Services.
If you are denied eligibility to receive the low income subsidy contact your local Legal Aid Office.
To find other Legal Aid of North Carolina materials, including any materials mentioned in this document, go to LawhelpNC.org/. If you need legal help please go to legalaidnc.org/.