Medicare, Medicaid, "Extra Help" and Low-Income Subsidy (LIS)

As a reminder, Medicare is government sponsored health insurance for people

• age 65 or older,
• under age 65 with certain disabilities, and
• any age person with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant). However this rule is changing. Beginning in 2021, you can join a Medicare Advantage plan (MA or MAPD) even If you have End-Stage Renal Disease.
• Medicare Part A covers in-patient or hospital care (and more).
• Medicare Part B covers out-patient or doctor visits (and more).
• Medicare Part D covers out-patient prescription drugs (with some limitations).
• Medicare Part C or Medicare Advantage plans implement Medicare Part A and Medicare Part B coverage and may include Medicare Part D coverage (and maybe more).

Medicaid is a joint Federal and State program helping people who have limited income and resources with medical costs. Medicaid programs vary from state to state, but most of your health care costs are covered if you qualify for both Medicare and Medicaid (also called dual-eligible). People with Medicaid may get coverage for services that are not fully covered by Medicare, such as nursing home and home health care (check with your state for more details). Who qualifies for the Medicaid program? The income limits for Medicaid vary from state to state. Contact your State Medical Assistance (Medicaid) office to see if you qualify.

How do I apply for the Medicaid program? You can contact your State Medical Assistance (Medicaid) office for more information about Medicaid benefits. You can also visit www.medicare.gov on the web or call 1-800-MEDICARE (1-800-633-4227) to get the telephone number for your State Medical Assistance office. TTY users should call 1-877-486-2048.

The Medicare Part D Extra Help or Low-Income Subsidy (LIS) program helps people with limited financial resources pay for their Medicare Part D prescription drug coverage. For more information, you can read below and see Extra help paying for Medicare prescription drug coverage If you receive Medicare Part D Extra Help, you may pay a lower or no monthly premium, a lower or no initial deductible, have coverage in the Donut Hole or Coverage Gap, and pay very little for your prescription drugs that are covered by your Medicare Part D plan.

If you qualify for Medicaid, you automatically qualify for the Medicare Part D "Extra Help" program that may lower the cost of your prescription drugs.