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Are you eligible for lower prescription costs through LIS?

Seniors receiving counseling about insurance, Medicare and Medicaid
Seniors receiving counseling about insurance, Medicare and Medicaid

By Kim Smallcombe, CHW, MMAP Regional/Program Coordinator, CareWell Services SW

The Low-Income Subsidy (LIS), also known as Extra Help, is a Medicare program to help people with limited income and resources pay for Medicare prescription drug costs, like premiums, deductibles, and coinsurance. The LIS program is more generous than Medicaid for income and asset eligibility, so it can be of help even if you don’t qualify for Medicaid. As of January 1, 2024, the program has been expanded to help more people, with full eligibility up to 150% of the Federal Poverty Level!

What does this mean? 

$0 premiums, $0 deductibles, $4.50 copays for generics, $11.20 copays for brand-name prescriptions. 

Who qualifies?

Single individuals with total income up to $1902.50/month, $22,830/year*, assets up to $17,220

Married couples with total income up to $2575/month, $30,900/year*, assets up to $34,360

‘*These amounts are before deductions such as Part B premiums, assets do not include one home, one vehicle or your personal belongings

Beneficiaries who have the following assistance automatically qualify:

Both Medicare & Medicaid coverage (Dual-eligible)

Receive Supplemental Security Income (SSI) benefits

Get help from Medicaid to pay your Part B Medicare premiums (MSP)

More good news:

The plan has been expanded in 2024. If you already have partial LIS, you will automatically be upgraded to full coverage, as described above. If you don’t have Part D drug coverage, a plan will be automatically selected for you by Social Security to work in tandem with LIS. If you are eligible and previously paid late fees for Part D, or didn’t enroll because of those penalty fees, they are forgiven upon enrollment in this assistance program.

Need help applying or have Medicaid questions? Call MMAP at 1-800-803-7174.

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