Individuals with limited income and resources may qualify for extra help to pay for their prescription drug costs. Resources include your savings and stocks, but do not include your home or car. If you qualify, Medicare could pay for 75% or more of your drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. If Medicare pays only a portion of this premium, we will bill you for the amount that Medicare doesn’t cover.
You can see if you qualify by calling:
You can apply for extra help at: https://www.socialsecurity.gov/prescriptionhelp or by calling 1- 800-772-1213 (TTY 1-800-325-0778).
Your extra help status can also be provided to Zing Health by submitting Best Available Evidence. Best Available Evidence (BAE) is a document that shows you qualify for Extra Help with your prescription drug costs. Listed below are a examples of BAE documents that are accepted by Medicare:
In addition, Zing Health will accept any one of the following forms of evidence from beneficiaries or pharmacists to establish that a beneficiary is institutionalized and qualifies for zero cost-sharing:
For more information on “Extra Help” and examples of BAE documents, please refer to Chapter 2, Section 7 of your Evidence of Coverage.
Fax or mail BAE documents to:
ATTN: Enrollment Department
303 West Madison Street, Suite 800
Chicago, IL 60606
When we receive the evidence showing your copayment level, we will update our system so that you can pay the correct copayment when you get your next prescription at the pharmacy. If you overpay your copayment, we will reimburse you. We will forward a check to you in the amount of your overpayment or we will offset future copayments. If the pharmacy hasn’t collected a copayment from you and is carrying your copayment as a debt owed by you, we may make the payment directly to the pharmacy. If a state paid on your behalf, we may make payment directly to the state. Please contact Customer Service if you have questions (phone numbers are printed on the back cover of this booklet).
To learn more about the CMS policy regarding Best Available Evidence please click the link below:
If you are not granted extra help, you can appeal a decision by completing this form: