Medicare Extra Help / Low Income Subsidy (LIS)

Medicare Extra Help / Low Income Subsidy (LIS)

UPDATED Feb. 1, 2019.  You may qualify for Medicare Extra Help, which is also referred to as the Low Income Subsidy (LIS) to pay Prescription Drug Costs if you are enrolled in Medicare Part D. You are automatically qualified for Medicare Extra Help if you meet one of the following conditions:

If you do not automatically qualify, then you must meet one of the income and resource guidelines listed below to enroll in an LIS program.

 Programs - 2019

Types of Medicare Extra Help Programs – 2019

Low Income Subsidy (LIS) – Extra Help/ Medicare with full Medicaid coverage

  • Income: Single/Married income should be less than 100% of the Federal Poverty Level (FPL). Monthly income for single/couple should be below $1,012 / $1,372 (for 2018).
  • Full Extra Help Benefits:
    – No monthly premium
    – No annual deductible
    – Copayments of $1.25 for generic and $3.80 for brand name.
    – No coverage gap
    – No late enrollment penalty
    – No copay after $5,000 in total drug costs

Low Income Subsidy (LIS) – Extra Help/ Medicare with Medicare Savings Programs

  • Income: Single/Married income should be above 100% of the Federal Poverty Level (FPL). Monthly income for single/couple should be above $1,012 / $1,372 (for 2018).
  • Full Extra Help Benefits:
    – No monthly premium
    – No annual deductible
    – Copayments of $3.40 for generic and $8.50 for brand name
    – No coverage gap
    – No late enrollment penalty
    – No copay after $5,000 in total drug costs

Low Income Subsidy (LIS) – Extra Help/ Medicare without Medicaid or Medicare Savings Programs

  • Income: Single/Married income should be less than 135% of the Federal Poverty Level (FPL). Monthly income for single/couple should be below $1,366 / $1,852 (for 2018).
  • Resource Limit: Single/Married assets should be less than $9,060 / $14,340.
  • Full Extra Help Benefits:
    – No monthly premium
    – No annual deductible
    – Copayments of $3.40 for generic and $8.50 for brand name
    – No coverage gap
    – No late enrollment penalty
    – No copay after $5,000 in total drug costs

Low Income Subsidy (LIS) – Extra Help/ Medicare without Medicaid or Medicare Savings Programs

  • Income: Single/Married income should be less than 150% of the Federal Poverty Level (FPL). Monthly income for single/couple should be below $1,518 / $2,058 (for 2018).
  • Resource Limit: Single/Married assets should be less than $14,100 / $28,150.
  • Partial Extra Help Benefits:
    – You pay 25% to 75% of your monthly premium
    – $83.00 annual deductible
    – 15% coinsurance or the plan associated copay, whichever is less
    – After $5,000 in total drug costs, you will  pay no more than $3.35 for generic and $8.35 for brand name
    – No coverage gap
    – No late enrollment penalty

Resources include money in checking or savings accounts, stocks, and bonds. Not included are your home, car, burial plot, furniture, and other household and personal items.

How to Apply for Medicare Extra Help

You may apply in one of the following ways:

  • Apply online at www.ssa.gov/extrahelp/
  • Call Social Security (800.772.1213) to apply over the phone or to request an application
  • Apply at your local Social Security Office

After you apply, Social Security will review the application and send you a letter to let you know whether you are qualified for the Medicare Extra Help. 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.

If you do not qualify for Medicare Extra Help one year, you may reapply later whenever there are changes in your income.

US Government Sources

How Can Liberty Medicare Help?

Liberty Medicare is a leading insurance agency that specializes in Medicare insurance in Delaware, Illinois, Maryland, New Jersey, New York, Ohio, Pennsylvania, and Virginia. All our services are absolutely free to you. An essential part of our job is working with low-income senior citizens and providing suggestions on available Medicare Extra Help Programs that will help with your Prescription Drug Costs.

Contact us if you need advice on applying to one of the Low-Income Subsidy (LIS) Programs.

Get our Medicare Quotes, or give us a call at 877-657-7477, and you will be connected to a licensed agent/broker.