By: Laura R. Lucas, Life/Health/Medicare Insurance Agent 06/13/2019

Unfortunately, there are a lot of people in the United States that are living below the poverty level. Once you open your eyes, it can be shocking just how many you see and, sometimes, the conditions they are living in. These people deserve medical care and medicine just like anyone else. That is why Low-Income Subsidies came about. This allows people to access their much-needed medication without fear of giving up a meal in order to do it.

First, you must prove you have Medicaid and will still qualify for it in the future. To do that you need:

  • A copy of your Medicaid card (if you have one).
  • A copy of a state document that shows you have Medicaid.
  • A print-out from a state electronic enrollment file that shows you have Medicaid.
  • A screen print from your state’s Medicaid systems that shows you have Medicaid.
  • Any other document from your state that shows you have Medicaid.

All Medicare companies honor these rules. Below is an example of how it works when you go to the drug store.

Low-income subsidies and middle-income help

One option for those struggling with drug costs is the low-income subsidy. Beneficiaries with income below 150% of the poverty line are eligible for the low-income subsidy, which helps pay for all or part of the monthly premium, annual deductible and co-pays. CMS estimated that 12.5 million Part D beneficiaries were eligible for low-income subsidies in 2009.[3]

The subsidy award is given a level with the following effects for the 2013 benefit year:[citation needed]

Level Deductible Generic Copay Brand Copay Catastrophic Coverage
1 $0 $2.65 $6.60 $0 copays on all meds
2 $0 $1.15 $3.50 $0 copays on all meds
3 $0 $0 $0 $0 copays on all meds
4 $66 max 15% 15% $2.65 Generic & $6.60 Brand copays

Probably the most important benefit of Social Security Extra Help/LIS other than “free” is the fact that the beneficiary has no exposure to “donut hole” costs and can change plans monthly.

If you get Extra Help then you were reviewed by Social Security. This notice tells you whether you still qualify for Extra Help in the coming year. If you have any questions, call 1-800-MEDICARE (1-800-633-4227).

Or for more information go to www.ssa.gov. You will see a dark blue bar at the bottom of the screen saying: ‘Apply for Extra Help with Medicare Prescription Drug Plan Costs. At the bottom of the page is a button that says: ‘Apply Now.’ Click on that link and begin the process yourself.

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