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Medicare beneficiaries who have limited income and resources may qualify for extra help to pay for prescription drugs costs. This low-income subsidy from Medicare provides financial assistance for beneficiaries who have limited income and resources. Those who are eligible for this low-income subsidy will get help paying for their monthly premium, yearly deductible, prescription coinsurance and copayments and no gap in coverage.
Some people are automatically eligible for the low-income subsidy. Those include people who are: full benefit dual eligibles; SSI recipients with Medicare; Medicare Savings Programs participants.
Some people must apply through the Social Security Administration. This includes Medicare beneficiaries with income below 150% Fixed Poverty Level. (See the table below for income and asset eligibility information)
Generally, dual eligibles and others deemed eligible for low-income subsidy pay no Part D plan premiums or deductibles, but pay $1.15 or $2.65 for generic drugs and $3.50 or $6.60 for brand-name drugs, depending on their income.
Don’t be afraid to ask for assistance, often people who do not believe they can qualify for assistance, do. Click here for more information on the Low Income Subsidy.
Medicare beneficiaries may also be eligible for prescription assistance through Rx For Oklahoma. For more information on Rx For Oklahoma click here or call 1-877-794-6552.
Part D Extra Help Eligibility
Full Low-Income Subsidy (LIS)/Extra Help 2013
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Who
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Monthly Income Limit
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Assets Limits
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Premium
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Deductible
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Copy/ Coinsurance
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Duals residing in long-term care
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Meets state requirements
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Meets state requirements
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None
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None
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None
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Dual Eligibles and Medicare Savings Program Participants
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Meets state requirements
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Meets state requirements
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None
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None
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(<100%FPL) Copay: $1.15 Generic $3.50 Brand Name
(>100%FPL) Copay: $2.65 Generic $6.60 Brand Name
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Non-Dual Eligibles making less than 135% of Federal Poverty Level
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Single:
$1,292.63
Married:
$1,744.88
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Single:
$8,580
Married:
$13,620
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None
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None
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Copay: $2.65 Generic
$6.60 Brand Name
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Partial Low-Income Subsidy (LIS)/Extra Help 2013
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Monthly Income Limit
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Monthly Income Limit
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Assets Limits
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Premium
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Deductible
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Copy/ Coinsurance
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Non-Dual Eligibles making more than 135% of Federal Poverty Level
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Single:
$1,292.63
Married:
$1,744.88
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Single:
Between $8,580 and $13,300
Married:
Between $13,620 and $26,580
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No
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$66
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Coinsurance: 15%
Copay: $2.65 Generic
$6.60 Brand Name
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Non-Dual Eligibles making between 135-150% of Federal Poverty Level
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Single:
$1,436.25
Married:
$1,938.75
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Single:
$13,300
Married:
$26,580
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Sliding Scale
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$66
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Coinsurance: 15%
Copay: $2.65 Generic
$6.60 Brand Name
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