What is the Medicare Part D Extra Help/Low-Income Subsidy (LIS) Program?

Medicare Part D is known as Medicare’s prescription drug benefit. It is a federal program administered through private insurance companies. As a Medicare-eligible beneficiary, you have two options for prescription drug coverage:

  1. You can enroll in a standalone Medicare Part D plan along with Original Medicare (Parts A and B) OR
  2. You can enroll in a Medicare Advantage (MA) plan with Part D coverage (MAPD)

Did you know you can qualify for Extra Help for your Medicare prescription drug plan costs? The Low-Income Subsidy (LIS) program helps you pay for a portion of Part D prescription drug plan costs, including Part D premiums, deductibles and copayments. Whether or not you qualify for a full subsidy or a partial subsidy depends on your income and assets.

You can receive the LIS benefit if you are enrolled in an MAPD plan. (Note, all Aspire Health Plans are MAPD plans.) LIS covers some or all your premium that goes toward your prescription drug benefit. Just remember you may still be responsible for the premium that goes towards your hospital and medical benefits. The savings on your overall premium are always tied to the Part D benchmark for each year.

In California, you are automatically enrolled in a Part D plan with the Extra Help/Low-Income Subsidy (LIS) program if you qualify for Medi-Cal or certain types of Medicare Savings Programs (MSPs). If you do not automatically qualify, you can apply for Extra Help (LIS) through the Social Security Administration (SSA) online, over the phone by calling 1-800-772-1213 (TTY 1-800-325-0778) or at your local Social Security Office (not during COVID-19). In 2021, to qualify for Extra Help, your resources must be limited to $14,790 for an individual or $29,520 for a married couple living together. Learn more from the SSA.

Your family member, caregiver or another third party can help you apply for Extra Help. Just remember, they must answer the questions as if they were you completing the application. Aspire Health Plan is happy to help you find financial assistance. Give Member Services a call at (855) 570-1600. TTY users call 711.


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