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|I am qualified for Medicaid and receive full Medicare Part D Extra Help, so why is my 2016 Medicare drug plan charging me a $3.80 premium in 2017? |
|Published on 2017-01-02 15:30:54||Category: Medicaid, LIS, & Extra Help|
|Your chosen 2016 Medicare Part D plan no longer qualifies for your state's full-benefit LIS $0 monthly premium in 2017.|
For example, the 2016 Florida AARP MedicareRx Saver Plus (PDP) plan qualified for the full-LIS
$0 monthly premium. However, the same AARP Part
D plan no longer qualifies for the $0 premium in 2017. Rather, the monthly premium for people with a 100% LIS benefit is $3.80.
And for more details: You can click here to read more about how to view the full (100% LIS) or partial LIS premiums for any Medicare Part D plan.
See the chart below
for more 2017 prescription plans that no longer qualify for the $0 monthly premium
in 2017, but did qualify in 2016.
As background: If you are qualified
to receive Medicaid, then you automatically qualify for the Medicare Part D Extra Help program and the cost of your Medicare Part D premium will be covered up to a certain
level – called your state’s Low-Income Subsidy (LIS) Benchmark Premium.
if you live in a state with a benchmark premium of $25, the Medicare Part D
Extra Help program will pay for the premium up to this level (or slightly
above) and you will have a $0 premium.
But if you monthly premium
over this $25 amount, you will be charged the additional cost over this
benchmark. So, in our example, if you Medicare plan has a $30 monthly
premium, you may be charged the $5 additional cost over your state's
2017 LIS Benchmark Premiums: You can
see a list of the 2017 Medicare Part D benchmark premiums for each state in our Blog: “2017
Low-Income Subsidy Benchmark Premium Amounts (includes 2017 - 2006 for
The good news is that, if you qualify for the full Medicare Part D Low-Income Subsidy (LIS or Extra Help), each year Medicare
will automatically enroll you in a Medicare Part D plan that qualifies for your
state’s $0 monthly premium.
have the right to select your own Medicare Part D plan at any time
during the plan year.
Important: If you select your own plan, Medicare considers
you a "Chooser" and does not automatically change your
enrollment for the next plan year -- even if your selected Medicare Part D plan
no longer qualifies for the state’s full-LIS $0 monthly premium.
The good news is that since you do receive "Extra Help" you can change your Medicare Part D plan at any time throughout the year to a drug plan that does qualify for the $0 monthly premium (and covers all of your medication needs) and your new coverage will take effect on the first day of the month after your enrollment.
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