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Medicare Part D Low Income Subsidy (LIS) Extra Help

PostPosted: Tue Oct 24, 2006 8:08 pm
by jimithy
This is the official Medicare Low Income Subsidy (LIS) Action Plan. Hopefully someone further down this thread will simplify it and summarize it better than the gov did. :D

Low Income Subsidy (LIS) Action Plan - Special Enrollment Period of May 16-November 15, 2006

Basic Facts about the LIS/Extra Help

To date, more than 9 million people with Medicare who qualify for extra help are getting continuous prescription drug coverage from Medicare at low cost.

People who apply and are approved for the extra help can join a Medicare drug plan and pay no penalty between now and December 31, 2006.

This one-time enrollment opportunity allows people to enroll in a Medicare prescription drug plan right after they become eligible for the extra help.

There is no cost or obligation to apply for extra help, so anyone who thinks they may qualify should apply through Social Security or their State Medicaid office.

Beneficiaries can apply for the extra help/LIS at any time.

The earlier beneficiaries apply for the extra help, the sooner they can take advantage of a benefit worth around $3,700 a year that pays for 95 percent of drug costs on average.

People who qualify for the full low-income subsidy get extra help to pay their full premiums and deductibles in certain plans and have minimal cost sharing.

Full-benefit dual eligible low-income beneficiaries have no premium or deductible and nominal co-pays of as little as $1 or $3 per prescription.

Dual eligible beneficiaries who are institutionalized are totally exempt from cost sharing. They pay no premiums, no deductibles, no coinsurance, and no co-payments.

Medicare beneficiaries who are not full-benefit dual eligibles, but whose incomes are less than 135 percent of the federal poverty level and who have limited assets, will also pay only a few dollars per prescription, with no premium or deductible.

People who qualify for the partial low-income subsidy will get extra help and pay reduced premiums, deductibles, and cost sharing.

For beneficiaries with incomes less than 150 percent of the federal poverty level and assets up to $10,000 (or $20,000 if married) in 2006, the

Medicare beneficiary in certain plans will only pay a $50 deductible, cost sharing up to 15 percent coinsurance, and a sliding-scale premium based on income, covering 85 percent of their drug costs on average.

Medicare is enrolling people who qualify for extra help into Medicare \r\nPrescription Drug Plans to make sure they get help paying for their prescription drug costs, if they don’t enroll themselves or decline coverage. These people include people who get Supplemental Security Income (SSI) benefits, or belong to Medicare Savings Programs (MSP), or apply and qualify for extra help and currently get their benefits through the Original Medicare Plan.\r\n\r\nThis facilitated enrollment process will ensure that people who qualify for extra help have prescription drug coverage.

Helping People on Medicare Apply for Extra Help

PostPosted: Tue Oct 24, 2006 8:29 pm
by NoPocketCash
Helping People on Medicare Apply for Extra Help', 'This Low Income Subsidy / Extra Help info from above appears to be geared towards gov employees... telling them who easily qualifies for assistance in the process of applying for help. Here is more info I believe the gov put out for their employees.

Helping People on Medicare Apply for Extra Help

You continue to be a valuable resource in helping people with Medicare apply for extra help paying their Medicare drug plan costs. A person may qualify for extra help if they have limited income and resources. Read below for more detailed information.

• Limited income (below $14,700 for an individual or $19,800 for a married couple living together). Even if their annual income is higher, a person still may be able to get some help with their prescription costs. Some examples where income may be higher include if a person or their spouse support other family members, who live with them, or have earnings from work, or live in Alaska or Hawaii.

The following cash payments don’t count as income:
• Food stamp assistance
• Home energy assistance
• Medical care assistance
• Housing assistance
• Disaster assistance
• Earned income tax credit payments
• Victim’s compensation
• Scholarships and education grants
• Limited resources (below $10,000 for an individual or $20,000 for a married couple living together). These resource limits can be slightly higher (an additional $1,500 per person) if a person will use some of the money for burial expenses.

The following items don’t count as a resource:

• Your primary residence
• Your personal possessions
• Your vehicle(s)
• Resources you could not easily convert to cash, such as jewelry or home
• Property you need for self-support, such as rental property or land you use to grow produce for home consumption
• Non-business property essential to your self-support
• Up to $1,500 (or $3,000 if you are married and living with your spouse) of
the cash value of life insurance policies
• Burial spaces

Social Security has a simple application process to help people with Medicare apply for extra help. There are several ways for people with Medicare to apply for extra help:

• Apply online at
• Get an application or apply over the phone by calling Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778.
• Attend a community event sponsored by Social Security or a civic or service organization where they can complete an application. Questions about extra
help will be answered at these events. Staff from Social Security’s 1,300 field offices are out in local communities taking applications at locations such
as senior centers, libraries and places of worship.
• Visit a local Social Security field office.

For more information about applying for extra help with your Medicare drug plan costs, call Social Security at 1-800-772-1213 or visit help on the web.

Where to find out about getting your Low Income Subsidy

PostPosted: Sun Apr 15, 2007 1:49 pm
by jimithy For people around the poverty line Medicare Part D Low Income Subsidy (LIS) - It is important to know that anyone with LIS for Medicare Part D there is NO DONUT HOLE!

Re: Medicare Part D Low Income Subsidy (LIS) Extra Help

PostPosted: Wed Aug 10, 2011 9:02 pm
by jimithy
updated and checked for broken links. 8/10/2011 by jimithy