Medicare

Medicare Low-Income Subsidy (LIS), or “Extra Help” with Prescription Drug Costs

Medicare patients who have limited income and resources may qualify for “Extra Help” to pay for prescription drugs. The LIS program from Medicare provides financial assistance for patients who may otherwise be unable to afford the costs associated with their Medicare Part D plan.

Those who are eligible for LIS may:

  • Receive assistance paying their monthly premium
  • Have a reduced or no deductible
  • Have reduced or no prescription coinsurance and co-payments
  • Have no gap in coverage

Eligibility

LIS for prescription drug costs is available in two ways:
  1. Automatic eligibility
  2. By application

Whether a beneficiary is deemed automatically eligible or must actively apply depends upon how he or she qualifies under the eligibility criteria.

Automatic eligibility
A Medicare patient will be deemed eligible for LIS and automatically enrolled in a Part D plan if he or she:

  • Qualifies for full Medicaid benefits (dual eligible); or
  • Receives Medicare premium and/or cost-sharing assistance; or
  • Receives Supplemental Security Income (SSI)

By application (eligible, but must apply)
Medicare patients who do not meet the criteria for automatic eligibility will not be automatically enrolled in a Part D plan and can submit an application to be considered for the LIS benefit if they meet income and asset-level requirements.

Available Resources

Visit AdvocacyConnector.com – Easy search connects you to national and/or state advocacy groups that offer resources most relevant to your needs:

  • Advocacy Help Lines
  • Alternative & Complementary Therapies
  • Caregiver Support
  • Clinical Research
  • Clinical Trials Information
  • Counseling/Depression
  • Emotional Support
  • Financial Assistance
  • Legal & Insurance Assistance
  • Materials in Other Languages (Spanish)
  • Nutrition
  • Pain Management
  • Patient Education & Support
  • Veterans’ Services
  • Wellness Activities/Exercise

Individuals can use the “Medicare Plan Finder” tool located at http://www.medicare.gov to obtain a list of LIS-eligible plans in their region.

2016 Open Enrollment Period Information

Open Enrollment Video

View Effects on Patient Costs and Enrollment Information

STANDARD MEDICARE PART D – Benefit design for brand name medications

 

 

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