Medicare Extra Help: 2019 Low-Income Subsidy Copayments

Medicare Extra Help 2017

The Federal Medicare Extra Help program, also referred as the Low Income Subsidy (LIS) program, is for people with full Medicaid coverage as well as for people who are not on Medicaid but who have limited income. (See Medicare Extra Help / Low Income Subsidy (LIS)). Here are 2019 Low-Income Subsidy Copayments.

2019 Low-Income Subsidy Copayments

  • Full Benefit Dual Eligibles Institutionalized or Receiving Home and Community-Based Services (HCBS): $0
  • Full Benefit Dual Eligibles with Incomes <= 100% of Federal Poverty Level
    • Generic/Preferred Drugs: $1.25
    • Other: $3.80
    • Above Catastrophic Limit: $0.00
  • Full Benefit Dual with Incomes > 100% of Federal Poverty Level & Other Full-Subsidy Eligible Beneficiaries
    • Deductible: $0
    • Generic/Preferred Drugs: $3.40
    • Other: $8.50
    • Above Catastrophic Limit: $0.00
  •  Beneficiaries with QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources ≤ $9,060 (individuals in 2018) or ≤ $14,340 (couples, 2018)
    • Beneficiaries
    • Deductible: $0
    • Generic/Preferred Drugs: $3.40
    • Other: $8.50
    • Above Catastrophic Limit: $0.00
  • Beneficiaries with income below 150% FPL and resources between $14,100 (individual, 2018) or $28,150 (couples, 2018)
    • Deductible: $85.00
    • Coinsurance to Initial Coverage Limit: 15%
    • Generics Above Catastrophic Limit: $3.40
    • Others Above Catastrophic Limit: $8.50

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