Based on the Centers for Medicare and Medicaid Services (CMS) recently released 2021
Medicare Part D prescription drug plan (PDP) landscape data, most states will offer
slightly more
Medicare Part D plans qualify for the Low-Income Subsidy (LIS) $0 premium
benchmark
in 2021 as compared to 2020.
Overall, twenty-five (25) states will add LIS qualifying plan options,
11 states will continue to have the same number of options, and
15 states will lose some LIS $0 premium qualifying Medicare Part D plans.
However, even though the total number of $0 premium LIS-qualifying plans
increased in 2021 (see second chart below), the average number of $0
premium LIS-qualifying plans per state will decrease slightly.
Alternatively, New York will be losing two LIS $0 qualifying Medicare Part D plan in 2021,
so lower-income New York residents will only have access to
seven 2021 Medicare Part D plans qualifying
for the state’s Low-Income Subsidy (LIS) $0 premium
benchmark.
The states with the smallest selection of $0-premium LIS 2021 Medicare Part D plans are...
The states with the smallest selection of 2021 Medicare Part D plans qualifying for the
LIS $0 premium are
Florida,
Hawaii,
Ohio, and
South Carolina -- all offering only five (5) LIS $0-premium qualifying Medicare Part D plans.
The states with the largest selection of LIS-qualifying $0 premium Medicare Part D plans are...
The states offering the largest selection of $0 premium LIS plans are
Arizona,
Illinois,
Pennsylvania, and
West Virginia -- all with 10 LIS plans.
The state with the most Medicare beneficiaries qualifying for the low-income subsidy (LIS or Extra Help Program) is California (almost 1.6 million “Extra Help” recipients). In 2021, California LIS recipients will have seven (7) Medicare Part D plan choices qualifying for the $0 premium (down from eight LIS $0 premium Part D plans in 2020). Which Medicare Part D plan providers are offering 2021 LIS-qualifying plans?
From our national stand-alone PDP-Facts page, here is a table showing a comparison of the 2020 and 2021 Medicare Part D plans qualifying for the $0 premium Low-Income Subsidy.
$0 Premium LIS Qualified stand-alone 2021 Medicare Part D Plans (as compared to 2020)
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Note: Not all Medicare Part D plans are available in every state. You can click the chart heading above to see plan details in California or choose your state.
Historical changes in the total number of LIS-qualifying Medicare Part D plans
Over the past years, the number of Medicare Part D plans qualifying for the $0-premium Low-Income Subsidy has begun to increase, paralleling the steady increase in the total number of stand-alone Medicare Part D plans across the country. The average number of LIS-qualifying plans on a state-by-state basis has somewhat stabilized (with an average of between 14 to 16 plans each year).
- Arizona and New York are losing two (2) LIS $0 premium plans
- Thirteen states are losing one LIS $0 premium plan
- Eleven (11) states have no change in the number of LIS $0 premium plans being offered
- Twenty (20) states are gaining one LIS $0 premium plan
- Three (3) states are gaining two LIS $0 premium plans
- Texas and Ohio are gaining three LIS $0 premium plans
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 2021 premium for your state in our
state low-income subsidy (LIS) benchmark limits
article to see qualifying plans in your state.
More on Medicare Part D Extra Help
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. Based on a person’s income and financial resources, the Extra Help or LIS program pays all or part of a person’s monthly Medicare Part D plan premiums and a significant portion of the beneficiary’s medication costs.
If you qualify for the full-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.
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 full - or partial-LIS benefits.
The PDP-Finder.com feature looks like this:
Because of changes in the annual Medicare Part D plan premiums and state LIS benchmarks,
some full low-income subsidy qualifying Medicare beneficiaries (such as people who are
Medicare/Medicaid dual-eligible beneficiaries) may be automatically reassigned to new
2021 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
2021 LIS qualifying plan and may need to select a new
2021 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.