Medicare Low Income Subsidy (LIS) – 2019

Medicare Extra Help (Low Income Subsidy) for 2019

The Federal Medicare Extra Help program also referred as the Medicare 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)).

Medicare Low Income Subsidy (LIS) – 2019

Here are 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 an income below 135% FPL and resources below $9,060 (individuals) and below $14,340 (couples)
    • 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 $9,060 and $14,100 (individuals) or between $14,340 and $28,150 (couples)
    • Deductible: $85.00
    • Coinsurance to Initial Coverage Limit: 15%
    • Generics Above Catastrophic Limit: $3.40
    • Others Above Catastrophic Limit: $8.50

How to Apply?

To apply for Low Income Subsidy (LIS), complete the Social Security Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020).

You may do it one of three ways:

  • Apply online at www.ssa.gov/extrahelp; or
  • Call Social Security at 1-800-772-1213 to apply over the phone or to request an application; or
  • Apply at your local Social Security office.

After you apply, Social Security will review the application and send you a letter informing whether you are qualified for Low Income Subsidy. Once you qualify, you can choose a Medicare Prescription Drug plan. If you do not select a plan, the Center for Medicare and Medicaid Services will do it for you. The sooner you join a plan, the sooner you begin receiving benefits.

To learn more, read Extra Help with Medicare Prescription Drug Plan Costs

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