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.
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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).
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.