Extra Help Copays 2021
The Federal Medicare Extra Help program also referred as the Medicare Low Income Subsidy (LIS) program, is for people with full Medicaid coverage as well as for people who are not on Medicaid but who have limited income. (See Medicare Extra Help / Low Income Subsidy (LIS)).
There are two levels of Extra Help: Full and Partial. Income eligibility is the same throughout the country, with slightly higher levels for Alaska and Hawaii. Discover what the income and asset eligibility thresholds are for the Part D Low Income Subsidy/Extra Help in 2021 in this handy chart. Who Qualifies for 'Extra Help'? For the plan year 2021 If your income is below $19,320 per year for a single person (or $26,130 for a married couple living together or even more if you have dependent children or grandchildren living with you), AND if your assets (resources) are below $13,290. for a single person (or $26,520. if you are married).
If a Silver plan's copayment is $30 for a doctor's visit, if you enroll in the plan and qualify for extra savings, you may pay $20 or $15 instead. You'll have a lower 'out-of-pocket maximum.' This means the total amount you'd have to pay in a year if you used a lot of care, like if you got seriously sick or had an accident, would be lower. UPDATED 1.22.2021. 2021 Extra Help/LIS copay levels & costs. People on these programs are “deemed” eligible for LIS – they don’t need to apply! Beneficiary group Monthly income. Monthly premium. Annual deductible. Total covered spending: ≤$9,314 $9, 314 Income and assets vary by program rules Full Medicaid.
Lis Subsidy Chart 2021
Medicare Low Income Subsidy (LIS) – 2021
Here are 2020 Low-Income Subsidy Copayments:
- Full Benefit Dual Eligibles Institutionalized or Receiving Home and Community-Based Services (HCBS): $0
- Full Benefit Dual Eligibles with Incomes <= 100% of Federal Poverty Level
- Generic/Preferred Drugs: $1.30
- Other: $4.00
- Above Catastrophic Limit: $0.00
- Full Benefit Dual with Incomes > 100% of Federal Poverty Level & Other Full-Subsidy Eligible Beneficiaries
- Deductible: $0
- Generic/Preferred Drugs: $3.70
- Other: $9.20
- Above Catastrophic Limit: $0.00
- Beneficiaries with QMB/SLMB/QI, SSI or applied an income below 135% FPL and resources below $9,360 (individuals, 2021) and below $14,800 (couples, 2021)
- Beneficiaries
- Deductible: $0
- Generic/Preferred Drugs: $3.70
- Other: $9.20
- Above Catastrophic Limit: $0.00
- Beneficiaries with income below 150% FPL and resources between $9,361 and $14,610 (individuals, 2021) or between $14,801 and $29,160 (couples, 2021)
- Deductible: $92.00
- Coinsurance to Initial Coverage Limit: 15%
- Generics Above Catastrophic Limit: $3.70
- Others Above Catastrophic Limit: $9.20
How to Apply?
To apply for Low Income Subsidy (LIS), complete the Social Security Application for Extra Help with Medicare Prescription Drug Plan Costs (SSA-1020).
You may do it one of three ways:
- Apply online at www.ssa.gov/extrahelp; or
- Call Social Security at 1-800-772-1213 to apply over the phone or to request an application; or
- Apply at your local Social Security office.
After you apply, Social Security will review the application and send you a letter informing whether you are qualified for Low Income Subsidy. Once you qualify, you can choose a Medicare Prescription Drug plan. If you do not select a plan, the Center for Medicare and Medicaid Services will do it for you. The sooner you join a plan, the sooner you begin receiving benefits.
To learn more, read Extra Help with Medicare Prescription Drug Plan Costs
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2021 Extra Help Lis Chart
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2021 Lis Chart
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Lis Income Guidelines 2021
For help finding the best Medicare or Individual Health Plan for you, please contact Liberty Medicare or call us at 877-657-7477.