Thousands of PA Medicare Beneficiaries to Lose Automatic Extra Help: What You Need to Know
More than 69,000 Medicare beneficiaries in Pennsylvania will lose their automatic eligibility for the Extra Help program this year. This is due to the large number of Pennsylvanians who lost Medicaid coverage during the unwinding of the COVID-19 continuous eligibility protections. Many of those affected by the loss of Medicaid are individuals who also have Medicare. The U.S. Department of Health and Human Services will send grey notices to impacted beneficiaries, informing them that their Extra Help benefits will end on December 31, 2024. Those who lost Medicaid before July 1, 2024, will no longer automatically qualify for Extra Help after this year.
Recipients of this notice should promptly complete the accompanying application and submit it to the Social Security Administration to determine if they still qualify for Extra Help. While they are losing automatic eligibility, many individuals may still meet income and resource limitsto continue receiving Extra Help next year but will need to apply. Applications can also be submitted online at www.ssa.gov. No supporting documents are required —if the SSA needs further information to process the application, they will contact the Medicare beneficiary directly.
Pennsylvanians aged 65 and older may qualify for PACE or PACENET. Older adults, especially those losing Extra Help and who no longer meet the income or resource limits for that program, are encouraged to apply. PACE/PACENET can limit out-of-pocket medication costs and can either work with someone’s current Medicare prescription drug plan or serve as standalone coverage. Applying is quick and can be done by phone, online, email, or mail. The income limits are generous: $33,500 for a single person and $41,500 for a married couple, based on the previous year's income, with no resource limits. More information about PACE/PACENET is available here.
It's important to review your Medicare Part D or Medicare Advantage Plan during the Medicare Annual Open Enrollment Period, which runs from October 15th to December 7th. Any changes made during this period will take effect on January 1, 2025.
Medicare beneficiaries who miss the chance to change plans during the Medicare Annual Open Enrollment Period and lose their deemed status for the Extra Help Program are eligible for a special enrollment period. This special enrollment runs from January 1st to March 31st, provided the beneficiary was notified of their loss of deemed status before January 1st.
People who need help applying for Extra Help or PACE/PACENET can contact PA MEDI at 1-800-783-7067. To find your local PA MEDI telephone number or to view a list of current PA MEDI Events in your community, click here.
