Medicaid, Extra Help and LIS | Medicare Part D Guide

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).

Medicare is organized into four parts:

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, no initial deductible, and pay nothing or 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.

As we read above, there is financial extra help available to Medicare beneficiaries who have limited income and resources that pays for some health care and prescription drug costs. Depending on your income and resources, you might qualify for one or more of the following six programs:

The low-income subsidy (LIS) program or Medicare Part D Extra Help paying for Medicare prescription drug coverage, see Extra help paying for Medicare prescription drug coverage
Medicaid (help from your state), see Medicaid
Medicare Savings Programs (help from your state Medicaid program paying Medicare premiums), see Medicare Savings Programs (help from Medicaid paying Medicare premiums)
Supplemental Security Income (SSI) benefits, see Supplemental Security Income Benefits
The PACE Program (Programs of All-inclusive Care for the Elderly), see PACE
Programs for people who live in the U.S. Territories of Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa, see Programs for People who live in the U.S. Territories