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Almost all states will offer fewer 2022 stand-alone Medicare Part D plans (PDPs) qualifying for the Low-Income Subsidy (LIS) $0 premium

Category: Annual Medicare Plan Changes
Published on 2021-09-29 16:45:51


Based on the Centers for Medicare and Medicaid Services (CMS) recently released 2022 Medicare Part D prescription drug plan (PDP) landscape data, most states will offer fewer Medicare Part D plans qualify for the Low-Income Subsidy (LIS) $0 premium benchmark in 2022 as compared to 2021.

Overall, forty-eight (48) states will lose one or more LIS qualifying plan options, three states will continue to have the same number of options, and no states will add LIS $0 premium qualifying Medicare Part D plans.

The total number of $0 premium LIS-qualifying plans decreased in 2022 (see second chart below) from 259 qualifying plans in 2021 to 196 LIS plans in 2022.

The number of unique 2022 Medicare Part D plans that qualify for the LIS $0 premium has fallen to 11 prescription drug plans from 15 qualifying plans in 2021 - the lowest level since the start of the Medicare Part D program.

PDPs meeting LIS $0 premium 2007 to 2022

As an example of state plan changes, Texas will offer five (5) LIS $0 premium qualifying 2022 Medicare Part D plans as compared to the eight (8) LIS-qualifying plans in 2021.

The states with the smallest selection of $0-premium LIS 2022 Medicare Part D plans are . . .

The states with the smallest selection of 2022 Medicare Part D plans qualifying for the LIS $0 premium are Florida, Alaska, Ohio, and New York -- all offering only four (4) 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 Arizona whose residents will have nine (9) 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 1.6 million “Extra Help” recipients).  In 2022, California LIS recipients will have five (5) Medicare Part D plan choices qualifying for the $0 premium (down from seven LIS $0 premium Part D plans in 2021).

Which Medicare Part D plan providers are offering 2022 LIS-qualifying plans?

From our national stand-alone PDP-Facts page, here is a table showing a comparison of the 2021 and 2022 Medicare Part D plans qualifying for the $0 premium Low-Income Subsidy.

$0 Premium LIS Qualified stand-alone 2022 Medicare Part D Plans (as compared to 2021)

2022 LIS Qualifying Plans
Plan NamePlan ID
AARP MedicareRx Saver Plus (PDP) S5921
Banner Medicare Simple Rx (PDP) S3147
Blue Cross MedicareRx Basic (PDP) S5715
Blue MedicareRx Value (PDP) S6506
Cigna Secure Rx (PDP) S5617
Clear Spring Health Value Rx (PDP) S6946
Elixir RxSecure (PDP) S7694
Humana Basic Rx Plan (PDP) S5884
Humana Basic Rx Plan (PDP) S5552
SilverScript Choice (PDP) S5601
WellCare Classic (PDP) S4802
2021 LIS Qualifying Plans
Plan NamePlan ID
AARP MedicareRx Saver Plus (PDP) S5921
Blue MedicareRx Value (PDP) S6506
Cigna Secure Rx (PDP) S5617
Clear Spring Health Value Rx (PDP) S6946
CommunityCare Prescription Drug Plan (PDP) S1894
Elixir RxSecure (PDP) S7694
Exemplar Health Basic (PDP) S5660
Express Scripts Medicare - Value (PDP) S5983
Express Scripts Medicare - Value (PDP) S5660
Humana Basic Rx Plan (PDP) S5884
Humana Basic Rx Plan (PDP) S5552
Indy Health SaverRx (PDP) S3535
SilverScript Choice (PDP) S5601
WellCare Classic (PDP) S4802
WellCare Medicare Rx Saver (PDP) S5810

NoteNot 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 few years, the number of Medicare Part D plans qualifying for the $0-premium Low-Income Subsidy increased, paralleling the 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).  However, in 2022, we will see the first meaningful reduction in the number of LIS-qualifying plans.

total LIS qualifying PDPs compared to total PDPs

A few more 2022 LIS $0 premium facts:

  • Three (3) states have no change in the number of LIS $0 premium plans being offered
  • Sixteen (16) states are losing one LIS $0 premium plan
  • Twenty-one (21) states are losing two LIS $0 premium plans
  • Eleven (11) states are losing three LIS $0 premium plans
  • Arizona will have the most LIS $0 premium plan options nine (9).

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 2022 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.

150928_LIS_premium_details2_2016.jpg
As can be seen in the above graphic, if you qualify for only "partial-LIS benefits" (such as 50% LIS), you will also only pay a portion of the plan's monthly premium.

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:

160928_LIS_PDP_Finder2.jpg
The applicable monthly premium will be shown in the search results and can be found on our "Benefit Details" page, for example:

150928_LIS_premium_details_2016.jpg
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 full low-income subsidy qualifying Medicare beneficiaries (such as people who are Medicare/Medicaid dual-eligible beneficiaries) may be automatically reassigned to new 2022 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 2022 LIS qualifying plan and may need to select a new 2022 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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