If you have Medicare and you have limited income & assets, you may qualify for Extra Help to pay for your prescription drugs. This program is also known as LIS, or the Part D Low-Income Subsidy.
The Social Security Administration (SSA) and the Centers for Medicare & Medicaid Services (CMS) work together to provide the benefit. This article “What is LIS” will example everything you need to know.
Who qualifies for Extra Help?
If your monthly income is below $1,581 in 2020 ($2,134 for couples) and your assets are below specified limits (Up to $14,390 for single people and $28,720 for couples), you may be eligible for Extra Help. Even if your income or assets are above the eligibility limits, you could still qualify for Partial Extra Help. It never hurts to apply, the worst that can happen is that they can say is no.
People who are enrolled in both Medicaid and Medicare, people who receive Supplemental Security Income (SSI) and those who qualify for a Medicare Savings Program DO NOT need to apply for this program. If you are receiving any of these, you already have LIS benefits.
Benefits of Extra Help
The amount of Extra Help you get depends on your income and resources. You receive either a full-subsidy or a partial-subsidy.
The Extra Help program offers the following benefits:
- Pays for your Part D premium.
- It lowers the cost of your prescription drugs.
- Gives you a Special Enrollment Period (SEP) once per calendar quarter to switch between plans if you don’t like the one you have.
- Eliminates any Part D late enrollment penalty you may have incurred.
Remember that Extra Help is not a replacement for Part D or a plan on its own. You must still have a Part D plan to receive Medicare prescription drug coverage and Extra Help assistance. If you do not choose a plan, you will in most cases be automatically enrolled in one.
How can you apply for LIS?
- You should apply for LIS directly with the Social Security Administration.
- Go to your local Social Security Office or call them directly 1 (800) 772-1213
- You can also apply directly on the Social Security Website, click the link below.
How to keep Extra Help every year?
To keep your Extra Help benefits from year to year, you must continue to meet the eligibility requirements. Depending on your state and how you initially qualified for Extra Help, this process may be automatic or require that you submit information to confirm your continued eligibility.
The Social Security Administration (SSA) may send you a letter in August or September titled Social Security Administration Review of Your Eligibility for Extra Help. The letter outlines the financial and personal information you provided when you applied and asks if any of it has changed.
If you and your spouse applied for Extra Help together, you will receive only one letter. If you receive the letter, you must complete the enclosed Review of Your Eligibility form and send it back to SSA within 30 days. SSA will use your answers to decide if you still qualify for Extra Help and at what level (full or partial), depending on how your income and assets changed.
If you do not fill out and return the “Review Your Eligibility” form, your Extra Help assistance will end December 31.
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