Jul 7

Medicare Premiums Are Not Deducted from Annual Income When Determining Eligibility for Medicare Part D “Extra Help” (E.D. N.Y.)

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Maria Parra, appearing pro se, appealed a final agency decision denying her application for Medicare Part D “Extra Help” benefits. Extra Help provides eligible low-income individuals assistance with their Medicare Part D drug plan costs. To be eligible, an individual must have income below 150% of the federal poverty line applicable to the relevant family size and meet certain resource requirements. Parra argued that she was eligible for Extra Help because the $104.90 monthly Medicare premium deducted from her Social Security disability benefits effectively reduced her annual income to below the 150% eligibility threshold. The federal district court for the Eastern District of New York granted the Commissioner’s motion for judgment on the pleadings. The court held that Medicare premiums are not subtracted from an applicant’s annual income when determining Extra Help eligibility. Moreover, even if the premium amounts were excluded, the Commissioner’s findings were supported by substantial evidence that both Parra’s income and assets still exceeded the program requirements.

Parra v. Colvin, 2016 WL 755629 (E.D. N.Y. Feb. 25, 2016) (unpublished)