How does a consumer who qualifies for low income subsidy receive financial assistance for their part of Medicare Part D cost?
Asked by: Mr. Ward Sauer MD | Last update: July 25, 2025Score: 4.9/5 (32 votes)
How does a consumer who qualifies for low income subsidy receive financial assistance for their part of Medicare Part D?
The Extra Help program helps people with limited income and resources lower or cut Part D costs. Medicare Part D provides drug coverage. The Extra Help program helps with the cost of your prescription drugs, like deductibles and copays. You can apply for Extra Help any time before or after you enroll in Part D.
What kind of financial assistance does a consumer receive who qualifies for low income subsidy Quizlet?
The Low Income Subsidy (LIS), also called Extra Help, helps Medicare beneficiaries with their prescription drug expenses. It provides financial assistance to certain beneficiaries to help them pay for the cost of Medicare Part D which is prescription drug coverage.
What kind of financial assistance does a customer receive who qualifies for a low-income subsidy?
Medicare's Part D Low Income Subsidy (also called LIS, or "Extra Help") helps enrollees pay for their prescription drug costs. People with incomes of up to 150% of the Federal Poverty Level (FPL) are eligible for LIS/Extra Help. Learn how the LIS/Extra Help program works, who can get this benefit, and how to enroll.
How to qualify for a low income subsidy?
It is also known as the Part D Low-Income Subsidy (LIS). If your monthly income is up to $1,976 in 2025 ($2,664 for couples) and your assets are below specified limits, you may be eligible for Extra Help (see the Extra Help income and asset limit chart for details).
Medicare Low Income Subsidy Explained
Who qualifies for subsidy?
- In states that have expanded Medicaid coverage, your household income must be below 138% of the federal poverty level (FPL) to qualify.
- In all states, your household income must be between 100% and 400% FPL to qualify for a premium tax credit that can lower your insurance costs.
How do I qualify to get my Medicare premium paid?
Californians with an annual income of less than $20,121 for an individual or $27,214 for a couple are eligible for a Medicare Savings Program. These programs provide help from the State of California to pay for your Medicare premiums, and sometimes your deductibles and copayments.
How do you qualify for Medicare Part D?
- Have Medicare Part A (Hospital Insurance) or Part B (Medical Insurance).
- Live in the service area of the plan you want to join.
- Be a U.S. citizen or lawfully present in the U.S.
- Complete an enrollment request during a valid election period.
What is subsidy assistance?
What Is a Subsidy? A subsidy is a benefit given to an individual, business, or institution, usually by the government. It can be direct (such as cash payments) or indirect (such as tax breaks).
Is low income subsidy and extra help the same thing?
Also known as the Part D Low Income Subsidy (LIS), “Extra Help” is estimated to be worth about $5,300 per year. Here's a look at who qualifies, the benefits and how to apply.
Which of the following can the government provide for people with low incomes who are trying to buy health insurance?
Medicaid and the Children's Health Insurance Program (CHIP) provide free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities.
Which consumer is eligible for a stand-alone?
Enrollment in Medicare Part A and/or Part B: To be eligible for a standalone Medicare prescription drug plan, you must be enrolled in Medicare Part A and/or Part B. This includes individuals who are 65 years or older, as well as certain individuals under 65 with qualifying disabilities.
What are the extra help changes for 2024?
Starting January 1, 2024, you'll pay <up to $1.55 or $4.60 for generic drugs and up to $4.50 or $11.20 for brand-name drugs or $0> for each covered prescription you fill at one of your Medicare drug plan's participating pharmacies.
Who is eligible for the 2024 subsidy program?
In or after 2024, to be eligible for a full (100%) premium subsidy, the individual must have countable income less than 150% of the FPL for the applicable State and family size. Before 2024, the individual's countable income must be less than 135% of the FPL for the applicable State and family size.
What drugs are covered by Medicare Part D for seniors?
- HIV/AIDS treatments.
- Antidepressants.
- Antipsychotic medications.
- Anticonvulsive treatments for seizure disorders.
- Immunosuppressant drugs.
- Anticancer drugs (unless covered by Part B)
What provides assistance to those with low incomes and limited resources?
Medi-Cal is California's Medicaid program. This is a public health insurance program that provides free or low cost medical services for children and adults with limited income and resources.
Who gets subsidies?
While many industries receive government subsidies, three of the biggest beneficiaries are energy, agriculture, and transportation.
Do I qualify for a healthcare subsidy?
Who is eligible for an ACA subsidy? Subsidy eligibility is based on income (ACA-specific MAGI). To qualify for a subsidy, a household must have an income of at least 100% of the federal poverty level (or above 138% of the federal poverty level in states that have expanded Medicaid).
Who gets the benefit of a subsidy?
A subsidy is really just a negative or reverse tax. Instead of collecting money in the form of a tax, the government gives money to consumer or producers. In this video, we look at the subsidy wedge and who benefits the most from different subsidies.
What does Medicare Part D pay for?
Medicare drug coverage (also known as Medicare Part D) helps pay for the brand-name and generic drugs you need. It's offered to everyone with Medicare by insurance companies and other private companies approved by Medicare. You can get drug coverage 2 ways: Add Medicare drug coverage (Part D) to Original Medicare.
How do you qualify for extra help with Medicare?
Automatically qualify for Extra Help for any of these reasons: You have both Medicare and Medicaid. You're in a Medicare Savings Program (MSP). You get Supplemental Security Income (SSI) benefits.
Does everyone have to pay $170 a month for Medicare?
Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.
Who qualifies for $800 Medicare reimbursement?
Each eligible active or retired member on a contract with Medicare Part A and Part B, including covered spouses, can get their own $800 reimbursement. You can distribute this flyer to your eligible employees to let them know about this amazing benefit.
How do you qualify for $144 back from Medicare?
- Be enrolled Original Medicare (Parts A and B)
- Pay your own Part B premium.
- Live in the service area of a plan that offers a Part B giveback.