§ Copay assistance is not valid for prescriptions reimbursed under Medicare, Medicaid, or similar federal or state programs. ¶llel; Medicare Part D patients with an annual income of ≤150% of the FPL are eligible for LIS assistance (also called 'Extra Help').

• UPDATED 1.29.2020. 2020 Extra Help/LIS copay levels & costs. People on these programs are “deemed” eligible for LIS – they don’t need to apply! Beneficiary group Monthly income. Monthly premium. Annual deductible. Total covered spending: Income and assets vary by program rules Full Medicaid (Categorically.
• The Social Security Administration does not have an Estate Recovery Program for any LIS assistance. If an individual falls within the following guidelines, they should be referred to SSA: Annual Income limited to $18,735 for an individual or $25,365 for a married couple living together in.
• No No Copay: $3.60 generic/$8.95 brand Catastrophic Copay: $0 Partial Low-Income Subsidy (LIS)/Extra Help (2020) - ALASKA Beneficiary Group Income Eligibility Requirement Monthly Income Eligibility Requirement Asset Eligibility Requirement Need to apply for LIS? Monthly Premium Annual Deductible Copay/Coinsurance Plan’s Formulary Drugs.

The Federal Medicare Extra Help program also referred as the Medicare Low Income Subsidy (LIS) program, is for people with full Medicaid coverage as well as for people who are not on Medicaid but who have limited income. (See Medicare Extra Help / Low Income Subsidy (LIS)).

Medicare Low Income Subsidy (LIS) – 2021

Here are 2020 Low-Income Subsidy Copayments:

• Full Benefit Dual Eligibles Institutionalized or Receiving Home and Community-Based Services (HCBS): $0
• Full Benefit Dual Eligibles with Incomes <= 100% of Federal Poverty Level
  • Generic/Preferred Drugs: $1.30
  • Other: $4.00
  • Above Catastrophic Limit: $0.00

• Full Benefit Dual with Incomes > 100% of Federal Poverty Level & Other Full-Subsidy Eligible Beneficiaries
  • Deductible: $0
  • Generic/Preferred Drugs: $3.70
  • Other: $9.20
  • Above Catastrophic Limit: $0.00
• Beneficiaries with QMB/SLMB/QI, SSI or applied an income below 135% FPL and resources below $9,360 (individuals, 2021) and below $14,800 (couples, 2021)
  • Beneficiaries
  • Deductible: $0
  • Generic/Preferred Drugs: $3.70
  • Other: $9.20
  • Above Catastrophic Limit: $0.00
• Beneficiaries with income below 150% FPL and resources between $9,361 and $14,610 (individuals, 2021) or between $14,801 and $29,160 (couples, 2021)
  • Deductible: $92.00
  • Coinsurance to Initial Coverage Limit: 15%
  • Generics Above Catastrophic Limit: $3.70
  • Others Above Catastrophic Limit: $9.20

How to Apply?

To apply for Low Income Subsidy (LIS), complete the Social Security Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020).

You may do it one of three ways:

Lis Copays 2020 Income

• Apply online at www.ssa.gov/extrahelp; or
• Call Social Security at 1-800-772-1213 to apply over the phone or to request an application; or
• Apply at your local Social Security office.

After you apply, Social Security will review the application and send you a letter informing whether you are qualified for Low Income Subsidy. 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. The sooner you join a plan, the sooner you begin receiving benefits.

To learn more, read Extra Help with Medicare Prescription Drug Plan Costs

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UPDATED Nov. 27, 2020. 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:

• You have full Medicaid
• You are in one of the Medicare Savings Programs
• You receive Supplemental Security Income (SSI)

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.

Types of Medicare Extra Help Programs – 2021

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 $1,083 / $1,457.
• Full Extra Help Benefits:
  – No monthly premium
  – No annual deductible
  – Copayments of $1.30 for generic and $4.00 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

2020 Medicare Lis Copays

• Income: Single/Married income should be above 100% of the Federal Poverty Level (FPL) but below 135% of FPL. Monthly income for single/couple should be above $1,083 / $1,457 but below $1,456 / $1,960.
• Full Extra Help Benefits:
  – No monthly premium
  – No annual deductible
  – Copayments of $3.70 for generic and $9.20 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 $1,456 / $1,960.
• Resource Limit: Single/Married assets should be less than $9,360 / $14,800.
• Full Extra Help Benefits:
  – No monthly premium
  – No annual deductible
  – Copayments of $3.70 for generic and $9.20 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 $1,615 / $2,175.
• Resource Limit: Single/Married assets should be less than $14,610 / $29,160.
• Partial Extra Help Benefits:
  – You pay 25% to 75% of your monthly premium
  – $92.00 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 $3.70 for generic and $9.20 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.

Lis Copays 2020 List

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