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Fewer 2025 stand-alone Medicare Part D (PDP) plans qualify for the Low-Income Subsidy (LIS) $0 premium

Category: Annual Medicare plan changes
Published: Oct 03, 2024 06:01:33


On September 27, 2024, the Centers for Medicare and Medicaid Services (CMS) released the 2025 Medicare Part D prescription drug plan landscape data and "announced that average premiums, benefits, and plan choices for Medicare Advantage (MA) and the Medicare Part D prescription drug program will remain stable in 2025."

Our preliminary analysis of the Medicare Part D prescription drug plan (PDP) landscape shows significantly fewer 2025 stand-alone Medicare Part D PDP options and the total number of 2025 PDPs qualifying for the Low-Income Subsidy (LIS) $0 premium will also decrease to a historic low. Also, one of these qualifying plans in each state is currently sanctioned by Medicare and cannot accept new enrollments.

The total number of stand-alone 2025 Medicare Part D prescription drug plans across the country will decrease 26% to 524 Medicare PDPs from 709 PDPs currently offered in 2024.  The total number of PDPs offered across the country is the lowest since the 2006 start of the Medicare Part D program.  In addition, the total number of $0 premium LIS-qualifying PDPs decreased to its lowest level in 2025 (see chart below) from 126 qualifying plans in 2024 to 115 LIS $0 premium plans in 2025.

However, the good news is that 25 states will offer the same number or more $0 premium LIS-qualifying 2025 drug plan options as compared to 2024.

 

Total LIS qualifying PDPs compared to total PDPs

Number of unique 2025 $0 premium LIS Part D plans increases, although some states will still lose $0 premium LIS plan options.

On a positive note, the number of unique 2025 Medicare Part D plans that qualify for the LIS $0 premium will increase to ten (10) prescription drug plans from the nine (9) Part D plans available in both 2024 and 2023.

Unfortunately, 26 states will lose one or more Medicare Part D plans qualify for the Low-Income Subsidy (LIS) $0 premium benchmark in 2025 as compared to 2024. Overall, fifteen (15) states will continue to have the same number of options, seventeen (17) states will lose one (1) LIS qualifying plan option, and nine (9) states will lose two (2) LIS qualifying plan options.

PDPs meeting LIS $0 premium 2007 to 2025

As an example of state plan changes, Louisiana will offer four (4) LIS $0 premium qualifying 2025 Medicare Part D plans as compared to the six (6) LIS-qualifying plans in 2024.
  • The states with the smallest selection of $0-premium LIS 2025 Medicare Part D plans include . . .

The states with the smallest selection of 2025 Medicare Part D plans qualifying for the LIS $0 premium are Alaska, Delaware, Florida, Illinois, Maryland, Nevada, Ohio, South Carolina, Texas, and Washington, DC -- each offering only two (2) LIS $0-premium qualifying Medicare Part D plans.

  • The state with the largest selection of LIS-qualifying $0 premium Medicare Part D plans is . . .

The state offering the largest selection of $0 premium LIS plans is Wisconsin whose residents will have six (6) LIS plan options.

  • The state with the largest number of LIS recipients is . . .
The state with the most Medicare beneficiaries qualifying for the low-income subsidy (LIS or Extra Help Program) is California (over 1.79 million “Extra Help” recipients).  In 2025, California LIS recipients will have three (3) Medicare Part D plan choices qualifying for the $0 premium (the same number as 2024).


Question:  Which Medicare Part D plan providers are offering 2025 LIS-qualifying plans?

From our national stand-alone PDP-Facts page, here is a table showing a comparison of the nine 2024 and ten 2025 Medicare Part D plans qualifying for the $0 premium Low-Income Subsidy.  2024 $0 premium LIS qualifying plans no longer available in 2025 are highlighted in green.  Medicare Part D plans now offering $0 premium LIS plans in 2025 are highlighted in yellow.

$0 Premium LIS Qualified stand-alone 2025 Medicare Part D Plans (as compared to 2024)

2025 LIS Qualifying Plans
Plan NamePlan ID
AARP Medicare Rx Saver from UHC (PDP) S5921
Blue Cross MedicareRx Basic (PDP) S5715
Blue MedicareRx Value (PDP) S5726
Blue MedicareRx Value Plus (PDP) S2893
Cigna Healthcare Assurance Rx (PDP) S5617
Clear Spring Health Value Rx (PDP) S6946
Horizon Medicare Blue Rx Standard (PDP) S5993
Humana Basic Rx Plan (PDP) S5884
SilverScript Choice (PDP) S5601
Wellcare Classic (PDP) S4802
2024 LIS Qualifying Plans
Plan NamePlan ID
AARP Medicare Rx Basic from UHC (PDP)) S5921
Blue Cross MedicareRx Basic (PDP) S5715
Cigna Secure Rx (PDP) S5617
Clear Spring Health Value Rx (PDP) S6946
Farm Bureau Essential Rx (PDP) S2668
Humana Basic Rx Plan (PDP) S5884
Mutual of Omaha Rx Plus (PDP) S7126
SilverScript Choice (PDP) S5601
Wellcare Classic (PDP) S4802

NoteNot all Medicare Part D plans are available in every state.  You can click the chart heading above to see plan details in California (as an example state) or choose your state from the on the CA page.

Historical changes in the total number of LIS-qualifying Medicare Part D plans

Over the past few years, the number of Medicare Part D plans qualifying for the $0-premium Low-Income Subsidy stayed somewhat consistent, averaging between 14 to 16 plans each year.  However, in 2022 and 2023, there was a meaningful reduction in the number of LIS-qualifying plans - and 2025 follows with a further reduction to the historically lowest total number of LIS $0 premium plans (although an increase in the number of unique $0 premium LIS plans).

A summary 2025 LIS $0 premium facts:
  • Fifteen (15) states have no change in the number of LIS $0 premium plans being offered,

  • Seventeen (17) states are losing one LIS $0 premium plan,

  • Nine (9) states are losing two (2) LIS $0 premium plans,

  • Nine (9) states are gaining one LIS $0 premium plan,

  • New Jersey will gain three (3) LIS $0 premium plans, and

  • Wisconsin will to have the most LIS $0 premium plan options six (6).

Question:  Which Medicare Part D plans qualify for the full Low-Income Subsidy $0 premium in my state?

Each year, insurance companies adjust their Medicare Part D plan premiums, and some Medicare Part D plans raise their premiums and move their prescription drug plans above the state low-income subsidy (LIS) benchmark limits, while other Part D plan sponsors lower their monthly premiums so that their plans can qualify for a state’s $0 premium.

This means that the number of Medicare Part D plans qualifying for the LIS $0 premium can change each year.  Click on the 2025 premium for your state in our state low-income subsidy (LIS) benchmark limits article to see qualifying plans in your state.



More on the Medicare Part D Extra Help or Low-Income Subsidy (LIS) program

The Medicare Part D Extra Help or the Low-Income Subsidy (LIS) is a federal program helping low-income Medicare beneficiaries pay a portion of their Medicare Part D prescription drug costs. The Extra Help or LIS program pays the beneficiary’s monthly Medicare Part D plan premiums and a significant portion of the beneficiary’s medication costs.

If you qualify for the LIS program, you can choose a Medicare Part D plan that qualifies for your state’s $0 monthly premium or allow yourself to be automatically enrolled in a plan that qualifies for the $0 premium.  If you enroll in a Medicare Part D plan that does not qualify for the $0 premium, you will pay a portion of the premium.  If you choose your own Medicare Part D plan, the monthly premium amount you will pay is shown under the "Benefit Details" button on our Medicare Part D plan finder.

 

LIS premium details example

Please note, our Medicare Part D plan finder allows you to view the premiums of a Medicare Part D plan based on whether you receive LIS benefits.

The PDP-Finder.com feature looks like this:

LIS PDPFinder example
The applicable monthly premium will be shown in the search results and can be found on our "Benefit Details" page.

A Brief note about automatic plan reassignment and people who are "choosers"

Because of changes in the annual Medicare Part D plan premiums and state LIS benchmarks, some low-income subsidy qualifying Medicare beneficiaries (such as people who are Medicare/Medicaid dual-eligible beneficiaries) may be automatically reassigned to new 2025 Medicare Part D plans that will still qualify for the $0 monthly premium.

However, Extra Help recipients who "chose" their own plan in the past (these beneficiaries are also referred to as "choosers") may not be auto-reassigned to a new 2025 LIS qualifying plan and may need to select a new 2025 Medicare Part D plan or Medicare Advantage plan that includes drug coverage that still meets the $0 monthly premium threshold (or pay the small monthly premium).  As reference, you can use our PDP-Finder to see LIS qualifying plans in your state.  Be sure to select "Yes, show only plans that qualify for $0 premium".  Click here to see an example for Texas.

Not sure where to begin?

For more information on Medicare Part D plans that qualify for your state’s low-income $0 premium benchmark, please call Medicare toll-free at 1-800-633-4227 and speak with a Medicare representative to learn more about your Medicare Part D and Medicare Advantage plan options.








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