Medicare Extra Help and Low Income Subsidy (LIS)

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Extra Help – Low Income Subsidy (LIS) Premium

If you get Extra Help from Medicare to help pay for your Medicare prescription drug plan costs, your prescription drug costs will be lower than if you did not get Extra Help from Medicare.

For full details, please read the Low-Income Subsidy (LIS) Premium chart.

The Low Income Subsidy (LIS) or Extra help helps people with Medicare plans pay for their prescription drug costs and lowers the cost of prescription drug coverage. It is for people who have limited income and resources. If you qualify, you will get help paying for any Medicare drug plan's monthly premium, yearly deductible, and drug copayments. This extra help will count toward your out-of-pocket costs.

For full details on Memorial Hermann Health Plan, please refer to the Low-Income Subsidy (LIS) Premium chart.

Here are some ways you can qualify for Extra Help and get additional information:

  • If you get full Medicaid benefits, you may automatically be eligible for Extra Help. Medicare will mail you a letter with information about Extra Help when you qualify.
  • If you get any help from Medicaid paying your Medicare premiums or receive Supplemental Security Income, you will automatically get Extra Help and do not need to apply separately. However, you will still need to enroll in a Medicare prescription drug plan.
  • If you have limited income and resources and don’t get help from Medicaid, you can apply for Extra Help and enroll in a Medicare drug plan. Call (800) MEDICARE ((800) 633-4227), 24/7 (TTY (877) 486-2048).
  • You can also call Social Security at (800) 772-1213 to apply over the phone, request a paper application, or to schedule an appointment to apply at your local Social Security office. TTY users should call (800) 325-0778 between 8 a.m. and 7 p.m., Monday through Friday. You may get additional information or apply online.
  • Or call your state Medicaid Office or by going to the website for additional information and help finding office near you.

You may no longer qualify for Extra Help if your income and resources changed since last year and you no longer qualify for one of the programs listed above. You will be notified in the mail along with an application and postage-paid envelope if you no longer automatically qualify for Extra Help. If you still qualify for Extra Help but the level you qualify for is changing, you’ll get a notice in the mail that will show your new copayment amounts. You should apply for Extra Help even if you get these notices as you may qualify for Extra Help.

It’s free to apply for Extra Help. Apply as soon as possible to make sure you get Extra Help There are 3 ways to apply:

  1. Visit Social Security Administration.
  2. Call Social Security at (800) 772-1213 to apply by phone, get a paper application mailed to you, or make an appointment at your local Social Security office. TTY users can call (800) 325-0778.
  3. Visit or call (800) MEDICARE ((800) 633-4227) to get the phone number of your local Medicaid office. TTY users can call (877) 486-2048.

If you don’t qualify for Extra Help, look at these other options for lowering your prescription drug coverage costs:

  • Your state may have programs that can help pay your prescription drug costs. Contact your Medicaid office or State Health Insurance Assistance Program (SHIP) for more information. Visit Medicare website for your Medicaid office’s phone number, and visit SHIP website for your SHIP’s phone number.
  • You may re-apply for Extra Help at any time if your income and resources change.
  • You can also find additional resources to help you on the Medicare website or visit Social Security online for more resources.

Have more questions or want to learn more?

Do you have questions, concerns, need more information or documents? Call our Customer Service team today at (855) 645-8448 to learn more about your plan benefits, available resources and member services. Hours of operation are 7 days a week from 8 a.m. to 8 p.m. CT, during October 1 – March 31 and Monday – Friday from 8 a.m. to 8 p.m. CT, during April 1 – September 30.

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