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How to Qualify for Medicare Low Income Subsidies

by | Nov 7, 2019

Do you need some extra help? Low Income Subsidies (LIS), also called Extra Help, are available to help qualifying Medicare beneficiaries afford the costs of prescription drugs. To qualify for Extra Help, you need to meet the LIS resource limits.

The LIS resource limits for 2020 have been announced. Here’s what you need to know.

What Resources Are Counted?

When calculating your resources, some things count, and some things don’t count.

  • Do count resources in bank accounts, stocks and bonds, as well as other liquid resources that can be converted to cash within 20 days. Also include real estate if it is not your primary residence.
  • Do not count your primary residence, your car or life insurance policies.

What Are the 2020 Resource Limits?

The LIS resource limits depend on a couple of factors, including whether you are married or single. Additionally, you can qualify for either full or partial subsidies, and there are different resource limits depending on your level.

For 2020, the LIS resource limits are as follows:

  • $7,860 for a single individual for the full subsidy
  • $11,800 for a married couple for the full subsidy
  • $13,110 for a single individual for a partial subsidy
  • $26,160 for a married couple for a partial subsidy

Beneficiaries can get a burial expense allowance if some of their resources are intended for burial expenses. This can make a big difference. When including the burial expense allowance, the LIS resource limits for 2020 are as follows:

  • $9,360 for a single individual for the full subsidy
  • $14,800 for a married couple for the full subsidy
  • $14,610 for a single individual for a partial subsidy
  • $29,160 for a married couple for a partial subsidy

Applying for Extra Help

Some people are automatically enrolled in Extra Help. If you qualify automatically, you will receive a notice informing you of this. If you are not automatically enrolled – or if your automatic enrollment has ended – you can still apply for Extra Help.

To apply for Extra Help online, go to https://www.ssa.gov/benefits/medicare/prescriptionhelp/.

In addition to the LIS resource limits, you will need to meet some other requirements. For example, you must live in one of the 50 states or in the District of Columbia. Also, qualifying for Extra Help is not the same as enrolling in a Medicare Prescription Drug plan – you still need to select a plan and enroll in it.

If you receive Extra Help in 2020, you should not pay more than $3.60 for generic prescriptions or $8.95 for brand-name prescriptions that are covered under your plan. If you think you are being charged more than you should be, contact your plan.

If you’d like assistance with applying for a Low Income Subsidy Extra Help program, contact PTT Financial Services.