Waiving or Reducing Part D Costs

By Melissa A. Brown
eMedicareSupplements Contributor

Medicare recipients often ask if costs from Medicare Part D can be waived or reduced if the recipient is experiencing a financial setback or hardship. In short, Social Security does offer some relief if certain income levels are met.

Subsidies for low-income individuals are available to offset the costs of Part D policies. In some cases, prescription co-pays may also be reduced or waived.

A subsidy of about $2,100 may be available if:

• your income doesn’t exceed 135 percent to 149 percent of the federal poverty level according to the 2006 HHS Poverty Guidelines
• you have assets that do not exceed $11,500 or $23,000 for two married clients. Your home is not counted as an asset when calculating this amount.

For more information about eligibility, or to apply for assistance, visit the Social Security Administration.

There are other circumstances that could lead to a Part D client not having to pay the standard co-pay for a prescription:

• Residents of a long-term nursing home who are enrollees of Medicare Part D and Medicaid will have all co-pays waived.
• Co-pays are waived on certain drugs, such as generics, with some plans; however, the co-pay policies can change with these policies at any time.
• Some pharmacies may choose to waive co-pays for clients with a subsidy, for any prescription. This will not occur automatically; be sure to ask your pharmacist about it.