Help with Medicare prescription drug costs
Medicare offers Extra Help (sometimes called Low Income Subsidy or LIS) to people with low incomes and limited assets. If a member qualifies, they will get help with drug costs that Medicare doesn't cover including plan premium, drug deductible and prescription copays. Depending on the member's income and resources, they could save an average of $5,0001 per year.
Less than half of the people eligible for Extra Help sign up. If you think the member might qualify, have them submit an application.
Does the Member qualify for Extra Help?
To be eligible for help with drug costs, member must:
- Live in the United States or District of Columbia.²
- Qualify for Medicare Part A and/or be enrolled in Medicare Part B.
- Have less than $19,320 in annual income/$15,510 in assets (if single).³
- Have less than $26,130 in annual income/$30,950 in assets (if married).³
How does the member apply for Extra Help?
Find out if the member qualifies and learn more about applying for Extra Help at the SSA.gov website.
The Trust has also contracted with Public Consulting Group (PCG) to provide assistance if you think that a member will qualify for Extra Help. Contact PCG at 1-888-690-1008 (representatives are available Monday through Friday, 9 a.m. through 5 p.m., Eastern Time), or by email at PCGUAW@pcgus.com
Best Available Evidence policy
The federal Best Available Evidence (BAE) policy requires that the plan adjusts member's subsidy if they provide updated information that changes the level of Extra Help they receive. A memo on the CMS website explains the procedures for updating a person's level of Extra Help.
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