Medicaid, Medicare and Extra Help

Medicaid & AHCCCS

Because of the similarity in naming, Medicaid and Medicare, are sometimes confused with each other. Medicaid provides health coverage for individuals including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. As such, the Arizona Health Care Cost Containment System (AHCCCS) is the state-specific program for Arizona residents of any age needing financial assistance with health and medical costs. Since Medicaid is a “means-tested” program, individuals seeking benefits must qualify. Additional information on AHCCCS can be found online at https://azahcccs.gov/.

Medicare

Medicare is the US health insurance program for people who are 65 or older, certain younger people with disabilities as well as people with End-Stage Renal Disease (ESRD). Medicare has many parts and programs that seek to provide the needed benefits for older Americans including hospital insurance (Part A), medical insurance (Part B), Advantage Plans (Part C) and prescription drug coverage (Part D). There are other parts and programs for certain individuals that provide additional benefits. One such program is Medicare Extra Help.

Extra Help & Medicare

Extra Help is a program set up to assist low-income individuals on Medicare pay for prescription drug program costs, like premiums, deductibles, and coinsurance. As this program is set up to help limited income adults with prescription drug costs, individuals must be approved to receive the Extra Help subsidy. There are two categories, those who “must apply” and those who are in the group as “Deemed Eligibles”. Those in the “must apply” category are those that are not currently under another approved subsidy program and must apply for the Extra Help program directly. The “Deemed Eligible” group consists of those currently receiving an approved subsidy program such as Medicaid.¹

Adults that are currently approved for AHCCCS (Medicaid) are deemed eligible for the Medicare Extra Help program. The Social Security Administration states that the Extra Help is estimated to be worth about $5,000 per year.² That is a great benefit and “help” for those that are currently on a Medicare drug plan struggling to pay for prescription drugs.

When and How to Apply for Medicare Extra Help

New enrollees to the Medicare Extra Help Program receive a Special Enrollment Period and can enroll at any time. Those approved and receiving Extra Help have the opportunity to change their Medicare Advantage or Part D Drug Plan once every three months. If you are approaching Medicare eligibility or are currently on Medicare and are on AHCCCS we invite you to call our office at (480) 635-4050 or (928) 263-8500. Our Licensed Medicare Brokers can assist you in finding the right plan to maximize your benefits and coverage. Our agents are experienced and licensed specializing in Medicare Health Insurance providing Medicare (parts A and B), Medicare Supplemental Insurance, Medicare Advantage (Part C) and Medicare Prescription (Part D) plans. We serve Medicare recipients in every county in Arizona including in the cities of Phoenix, Mesa, Tempe, Chandler, Apache Junction, Gilbert, Tucson, Kingman, Bullhead City, Prescott, Flagstaff, Yuma, Sierra Vista and more. CSG Medicare Insurance Agents are independent, licensed and appointed with multiple insurance carriers to give you a wide variety of choice. For more information, call (480) 635-4050 or (928) 263-8500.