LIS Extra Help Insurance Guide
Low-Income Subsidy (LIS) Overview
The Low-Income Subsidy (LIS), also known as Extra Help, is a program provided by the Social Security Administration (SSA) to assist people with limited income and resources in paying for Medicare prescription drug costs (Part D). It helps eligible recipients pay for premiums, deductibles, copayments, and coinsurance associated with Medicare Part D. The goal is to make prescription drugs more affordable for people with limited income.
How LIS Works
LIS offers financial assistance based on the recipient's income and resources. There are several levels of subsidies depending on the individual's financial situation, which can significantly reduce their prescription drug costs.
Eligibility
To qualify for LIS, individuals must:
• Be enrolled in Medicare Part A and/or Part B.
• Have limited income and resources (income must generally be below 150% of the federal poverty level, and the resources must fall below a certain limit).
• Income limits vary annually, and resource limits include savings, bank accounts, and investments.
LIS Tiers (Subsidy Levels)
LIS is divided into different tiers, which determine the amount of assistance the recipient will receive for prescription drug costs. These tiers depend on the person’s income and resources.
1. Full Subsidy:
o Description: Those who qualify for the full subsidy have the lowest income and resources and get the most help.
o Benefits:
No premium for the Medicare Part D plan.
No deductible for prescription drugs.
Lower copayments and coinsurance.
o Impact on the Recipient: They pay very little for prescription drugs and have no premium or deductible costs, making medications significantly more affordable.
2. Partial Subsidy:
o Description: Individuals with slightly higher income and resources still qualify for partial help but are required to pay a portion of their drug costs.
o Benefits:
A reduced premium for their Medicare Part D plan.
A deductible (lower than those without LIS).
Reduced copayments and coinsurance.
o Impact on the Recipient: While the recipient still has to pay a premium, their total drug costs are lowered compared to individuals without LIS. The program helps reduce out-of-pocket expenses but does not cover all costs.
3. No Subsidy (for those not eligible):
o Description: If a person’s income or resources exceed the LIS limits, they do not qualify for LIS and must pay the full amount for Medicare Part D.
o Impact on the Recipient: They will need to pay full premiums, deductibles, and copayments for their prescription drugs, which can be expensive.
How LIS Affects the Recipient
• Lower Prescription Drug Costs: LIS can significantly reduce the cost of medications, making them more affordable. For those with chronic conditions, this can help ensure they stay on necessary medications without breaking their budget.
• No or Reduced Premiums: In the case of full subsidy recipients, the monthly premium for Medicare Part D can be entirely waived. For those who receive a partial subsidy, the premiums will be lower than those paid by individuals without LIS.
• Cost Sharing Reduction: Co-pays and deductibles are reduced, meaning recipients pay less out of pocket when filling prescriptions.
What Happens If Important Dates or Emails Aren’t Responded To in the Allotted Time?
• Failure to Respond to Eligibility Notices: If a recipient does not respond to LIS eligibility notices or requests for documentation (such as income verification) within the specified time frame, they risk losing eligibility for the program. They may then be required to pay full premiums and drug costs.
o Impact: If LIS eligibility is lost, the recipient will have to pay more for their prescription drugs. This could create financial strain, especially for those on multiple medications.
• Failure to Act During Open Enrollment: If a recipient misses the Medicare Open Enrollment period (usually from October 15 to December 7), they will not be able to apply for LIS until the next enrollment period unless they qualify for a Special Enrollment Period (SEP) due to a qualifying life event (e.g., moving, losing coverage,lost employment,income decreased,plan not available any longer).
o Impact: Missing open enrollment may delay enrollment in a new Part D plan or cause coverage gaps, resulting in a period without prescription drug coverage or financial assistance.
• Failure to Update Information: If the recipient fails to update their income or resource information during required reviews or changes in their status, they may be moved into a different subsidy tier or lose benefits altogether.
o Impact: They could lose financial assistance, which could significantly increase out-of-pocket costs for their medications.
How LIS Tiers Affect the Recipient
• Full Subsidy: Those in the full subsidy category pay little to nothing for their medications and Medicare Part D premiums. This is most beneficial to people with very low incomes and resources, allowing them to focus on their health without financial burden.
• Partial Subsidy: While recipients still pay a premium, their costs are much lower than those of people without LIS, reducing their financial strain. However, they still face some out-of-pocket expenses.
• No Subsidy: For those who do not qualify for LIS, the full cost of premiums and medications can be a heavy burden, particularly for those on multiple prescriptions.
Important Dates for LIS
• Annual LIS Re-Evaluation: Every year, Social Security will review the recipient’s eligibility for LIS. This includes reviewing income and resource levels.
o If there are any changes (e.g., income increases or resources exceed the limits), the recipient’s subsidy tier may change, or they may lose LIS coverage altogether.
• Medicare Open Enrollment (October 15 - December 7): During this period, recipients can review their current Medicare Part D plan and switch to another one if necessary. This is also the time to reapply for LIS if there are changes to income or resources.
How to Apply for LIS
Here’s a simple step-by-step guide you can use to assist people in filling out the form:
________________________________________
Step-by-Step Guide to Filling Out the LIS (SSA-1020) Form Online
Step 1: Access the Online Application
1. Go to the Official SSA Website:
o Visit the Social Security Administration website at LIS Extra Help Insurance Guide
Low-Income Subsidy (LIS) Overview
The Low-Income Subsidy (LIS), also known as Extra Help, is a program provided by the Social Security Administration (SSA) to assist people with limited income and resources in paying for Medicare prescription drug costs (Part D). It helps eligible recipients pay for premiums, deductibles, copayments, and coinsurance associated with Medicare Part D. The goal is to make prescription drugs more affordable for people with limited income.
How LIS Works
LIS offers financial assistance based on the recipient's income and resources. There are several levels of subsidies depending on the individual's financial situation, which can significantly reduce their prescription drug costs.
Eligibility
To qualify for LIS, individuals must:
• Be enrolled in Medicare Part A and/or Part B.
• Have limited income and resources (income must generally be below 150% of the federal poverty level, and the resources must fall below a certain limit).
• Income limits vary annually, and resource limits include savings, bank accounts, and investments.
LIS Tiers (Subsidy Levels)
LIS is divided into different tiers, which determine the amount of assistance the recipient will receive for prescription drug costs. These tiers depend on the person’s income and resources.
1. Full Subsidy:
o Description: Those who qualify for the full subsidy have the lowest income and resources and get the most help.
o Benefits:
No premium for the Medicare Part D plan.
No deductible for prescription drugs.
Lower copayments and coinsurance.
o Impact on the Recipient: They pay very little for prescription drugs and have no premium or deductible costs, making medications significantly more affordable.
2. Partial Subsidy:
o Description: Individuals with slightly higher income and resources still qualify for partial help but are required to pay a portion of their drug costs.
o Benefits:
A reduced premium for their Medicare Part D plan.
A deductible (lower than those without LIS).
Reduced copayments and coinsurance.
o Impact on the Recipient: While the recipient still has to pay a premium, their total drug costs are lowered compared to individuals without LIS. The program helps reduce out-of-pocket expenses but does not cover all costs.
3. No Subsidy (for those not eligible):
o Description: If a person’s income or resources exceed the LIS limits, they do not qualify for LIS and must pay the full amount for Medicare Part D.
o Impact on the Recipient: They will need to pay full premiums, deductibles, and copayments for their prescription drugs, which can be expensive.
How LIS Affects the Recipient
• Lower Prescription Drug Costs: LIS can significantly reduce the cost of medications, making them more affordable. For those with chronic conditions, this can help ensure they stay on necessary medications without breaking their budget.
• No or Reduced Premiums: In the case of full subsidy recipients, the monthly premium for Medicare Part D can be entirely waived. For those who receive a partial subsidy, the premiums will be lower than those paid by individuals without LIS.
• Cost Sharing Reduction: Co-pays and deductibles are reduced, meaning recipients pay less out of pocket when filling prescriptions.
What Happens If Important Dates or Emails Aren’t Responded To in the Allotted Time?
• Failure to Respond to Eligibility Notices: If a recipient does not respond to LIS eligibility notices or requests for documentation (such as income verification) within the specified time frame, they risk losing eligibility for the program. They may then be required to pay full premiums and drug costs.
o Impact: If LIS eligibility is lost, the recipient will have to pay more for their prescription drugs. This could create financial strain, especially for those on multiple medications.
• Failure to Act During Open Enrollment: If a recipient misses the Medicare Open Enrollment period (usually from October 15 to December 7), they will not be able to apply for LIS until the next enrollment period unless they qualify for a Special Enrollment Period (SEP) due to a qualifying life event (e.g., moving, losing coverage).
o Impact: Missing open enrollment may delay enrollment in a new Part D plan or cause coverage gaps, resulting in a period without prescription drug coverage or financial assistance.
• Failure to Update Information: If the recipient fails to update their income or resource information during required reviews or changes in their status, they may be moved into a different subsidy tier or lose benefits altogether.
o Impact: They could lose financial assistance, which could significantly increase out-of-pocket costs for their medications.
How LIS Tiers Affect the Recipient
• Full Subsidy: Those in the full subsidy category pay little to nothing for their medications and Medicare Part D premiums. This is most beneficial to people with very low incomes and resources, allowing them to focus on their health without financial burden.
• Partial Subsidy: While recipients still pay a premium, their costs are much lower than those of people without LIS, reducing their financial strain. However, they still face some out-of-pocket expenses.
• No Subsidy: For those who do not qualify for LIS, the full cost of premiums and medications can be a heavy burden, particularly for those on multiple prescriptions.
Important Dates for LIS
• Annual LIS Re-Evaluation: Every year, Social Security will review the recipient’s eligibility for LIS. This includes reviewing income and resource levels.
o If there are any changes (e.g., income increases or resources exceed the limits), the recipient’s subsidy tier may change, or they may lose LIS coverage altogether.
• Medicare Open Enrollment (October 15 - December 7): During this period, recipients can review their current Medicare Part D plan and switch to another one if necessary. This is also the time to reapply for LIS if there are changes to income or resources.
How to Apply for LIS
Here’s a simple step-by-step guide you can use to assist people in filling out the form:
________________________________________
Step-by-Step Guide to Filling Out the LIS (SSA-1020) Form Online
Step 1: Access the Online Application
1. Go to the Official SSA Website:
o Visit the Social Security Administration website at www.ssa.gov/extrahelp.
o Click on “Apply Online for Extra Help with Medicare Prescription Drug Costs” to start the process.
Step 2: Create or Log In to Your Social Security Account
2. Sign In to Your Social Security Account:
o If you already have a My Social Security account, sign in using your username and password.
o If you don’t have an account, click on Create an Account and follow the instructions to set up a new account.
Step 3: Personal Information Section
3. Fill Out Personal Details:
o Name: Enter your full legal name as it appears on your Medicare card.
o Date of Birth: Select your date of birth from the dropdown menu.
o Medicare Number: You will need to enter your Medicare number, which can be found on your Medicare card.
o Phone Number: Provide a phone number where you can be reached.
o Email Address: Add your email address for communication purposes (optional).
Step 4: Financial Information
4. Provide Income Details:
o You will be asked to enter your income details, including wages, Social Security benefits, pension income, etc.
o Be sure to have your latest tax return or other proof of income on hand, such as:
Social Security benefits statement (Form SSA-1099)
Income from work (pay stubs, tax returns)
Pension or other retirement income.
5. Report Other Resources:
o You’ll also need to provide information on your resources, including savings accounts, bank accounts, investments, and property.
o Resources should generally not exceed $15,510 for an individual or $30,950 for a married couple to qualify for full LIS.
Step 5: Provide Information on Health Insurance
6. Health Insurance Information:
o You will need to provide details about any other health insurance you have, such as:
Medicaid
Veterans’ benefits
Employer health insurance
Step 6: Complete and Submit the Form
7. Review Your Information:
o After filling out the entire form, review all the entered information carefully. Ensure everything is correct, especially your personal details, income, and resource information.
8. Submit the Form:
o Once everything is reviewed, click Submit to send your application to the Social Security Administration.
o You should receive a confirmation receipt and will be notified if additional documentation is needed.
Step 7: Follow-Up
9. Check Status:
o You can check the status of your application by logging back into your My Social Security account at any time.
o If additional information is required, the SSA will contact you by mail or email.
________________________________________
Additional Tips and FAQs
• What if I don't have online access?
If you do not have access to the internet or prefer not to apply online, you can also fill out a paper form (SSA-1020) and mail it to your local Social Security office. You can also request the form by calling the SSA at 1-800-772-1213.
• What documents do I need to gather?
o Medicare card.
o Proof of income (Social Security statements, tax returns, pay stubs, etc.).
o Bank account or asset details.
• What if I am already getting Medicaid?
If you are dual-eligible (both Medicare and Medicaid), you may automatically qualify for LIS, and you might not need to complete the application. You can check with the SSA or your Medicaid office to confirm your eligibility.
________________________________________
Where to Get Help
If you need help completing the online application, you can:
• Call SSA at 1-800-772-1213 for assistance with the LIS application process.
• Visit your local Social Security office or a Medicaid office for in-person support.
________________________________________
This guide will help applicants through the process of filling out the online LIS form (SSA-1020).
Recipients can apply for the Low-Income Subsidy through:
• The Social Security Administration (SSA) website.
• State Medicaid programs (in some cases).
• Direct contact with their Medicare prescription drug plan.
Contact Information for LIS
• Social Security Administration (SSA) Website: www.ssa.gov
• LIS Customer Service: If recipients need assistance, they can contact the SSA at 1-800-772-1213 or 1-800-325-0778 for TTY users.
Responding to emails and following through with deadlines for the Low-Income Subsidy is crucial to maintaining affordable access to prescription drug coverage under Medicare. Missing deadlines or failing to provide the necessary documentation can lead to higher costs and loss of benefits.
To apply for the Low-Income Subsidy (LIS), also known as Extra Help, using Google, follow these steps:
Steps to Apply for LIS via Google:
1. Open Google:
o Go to your preferred web browser and open Google (www.google.com).
2. Search for LIS Application:
o In the search bar, type "Apply for Low-Income Subsidy Medicare Extra Help" or "Apply for LIS Social Security" and press Enter.
3. Find the Official SSA Website:
o Look for the official Social Security Administration (SSA) website in the search results. The correct link will usually be www.ssa.gov or a page with "Social Security" in the URL.
o Click on the link that says "Apply for Extra Help with Medicare Prescription Drug Costs" or something similar.
4. Navigate to the Application Page:
o Once you are on the official SSA website, locate the page dedicated to Low-Income Subsidy (LIS) or Extra Help.
o This page should provide an option to either apply online or download an application form.
5. Apply Online:
o If you choose to apply online, click the button that says “Apply Online” or “Start Your Application”.
o You will be directed to an online form where you can enter your personal details, including income and resources information.
6. Fill in the Required Information:
o Complete the application by filling in details like:
Your Medicare number.
Income and resources information.
Personal details (e.g., name, address, Social Security number, etc.).
Other required information, which may include proof of income, assets, or medical expenses.
7. Submit the Application:
o After completing the form, review the information to ensure it is correct.
o Submit the application online through the SSA website.
8. Check the Status of Your Application:
o After applying, you can check the status of your application by logging into your My Social Security account on the SSA website.
9. Wait for the Decision:
o The SSA will review your application and notify you of your eligibility for LIS. This process can take several weeks.
10. Follow Up:
o If the SSA requests additional documentation or information, be sure to respond promptly to avoid delays or loss of benefits.
________________________________________
Alternatively, Apply by Phone or Mail:
• If you prefer not to apply online, you can also apply by phone by calling the Social Security Administration at 1-800-772-1213.
• You may also request a paper application to be mailed to you.
________________________________________
For more details, you can visit the official SSA website: www.ssa.gov/extrahelp.
To apply for the Low-Income Subsidy (LIS), also known as Extra Help, for recipients of Medicare and Medicaid, you can follow these steps to obtain and complete the application form:
How to Get the LIS Form:
1. Online Application:
o Visit the Social Security Administration (SSA) website directly to apply online for LIS:
Go to www.ssa.gov/extrahelp.
You can apply online through the “Apply Online for Extra Help with Medicare Prescription Drug Costs” link.
Complete the online form and submit it directly to SSA.
2. Paper Application:
o If you prefer to apply on paper, you can request a Low-Income Subsidy (LIS) application form from the SSA. Here's how:
Call 1-800-772-1213 to request the form by phone (TTY 1-800-325-0778 for hearing impaired).
Alternatively, visit your local Social Security office or the nearest Medicaid office to request a paper application form.
3. Download the Form:
o You can also download the LIS application form from the SSA website. Here are the steps:
Visit the SSA website www.ssa.gov.
Search for "Low-Income Subsidy (LIS) application form" or use this direct link: https://www.ssa.gov/forms/ssa-1020.pdf.
Download the SSA-1020 form (Application for Extra Help with Medicare Prescription Drug Plan Costs).
Print and complete the form, then mail it to the SSA or submit it to your local Social Security office.
SSA-1020 Form (Application for Extra Help):
• Form Name: SSA-1020
• Purpose: This is the official form used to apply for the Low-Income Subsidy (LIS).
• Where to Submit: You can mail the completed form to your local Social Security office or submit it online if you apply via the website.
Eligibility for LIS for Medicare and Medicaid Recipients:
• If you are already receiving Medicaid, you may automatically qualify for the full LIS subsidy, and you may not need to submit an application.
• Dual-eligible individuals (those who qualify for both Medicare and Medicaid) often automatically receive LIS, but it is essential to check with the Social Security Administration or your Medicaid office for confirmation.
.
o Click on “Apply Online for Extra Help with Medicare Prescription Drug Costs” to start the process.
Step 2: Create or Log In to Your Social Security Account
2. Sign In to Your Social Security Account:
o If you already have a My Social Security account, sign in using your username and password.
o If you don’t have an account, click on Create an Account and follow the instructions to set up a new account.
Step 3: Personal Information Section
3. Fill Out Personal Details:
o Name: Enter your full legal name as it appears on your Medicare card.
o Date of Birth: Select your date of birth from the dropdown menu.
o Medicare Number: You will need to enter your Medicare number, which can be found on your Medicare card.
o Phone Number: Provide a phone number where you can be reached.
o Email Address: Add your email address for communication purposes (optional).
Step 4: Financial Information
4. Provide Income Details:
o You will be asked to enter your income details, including wages, Social Security benefits, pension income, etc.
o Be sure to have your latest tax return or other proof of income on hand, such as:
Social Security benefits statement (Form SSA-1099)
Income from work (pay stubs, tax returns)
Pension or other retirement income.
5. Report Other Resources:
o You’ll also need to provide information on your resources, including savings accounts, bank accounts, investments, and property.
o Resources should generally not exceed $15,510 for an individual or $30,950 for a married couple to qualify for full LIS.
Step 5: Provide Information on Health Insurance
6. Health Insurance Information:
o You will need to provide details about any other health insurance you have, such as:
Medicaid
Veterans’ benefits
Employer health insurance
Step 6: Complete and Submit the Form
7. Review Your Information:
o After filling out the entire form, review all the entered information carefully. Ensure everything is correct, especially your personal details, income, and resource information.
8. Submit the Form:
o Once everything is reviewed, click Submit to send your application to the Social Security Administration.
o You should receive a confirmation receipt and will be notified if additional documentation is needed.
Step 7: Follow-Up
9. Check Status:
o You can check the status of your application by logging back into your My Social Security account at any time.
o If additional information is required, the SSA will contact you by mail or email.
________________________________________
Additional Tips and FAQs
• What if I don't have online access?
If you do not have access to the internet or prefer not to apply online, you can also fill out a paper form (SSA-1020) and mail it to your local Social Security office. You can also request the form by calling the SSA at 1-800-772-1213.
• What documents do I need to gather?
o Medicare card.
o Proof of income (Social Security statements, tax returns, pay stubs, etc.).
o Bank account or asset details.
• What if I am already getting Medicaid?
If you are dual-eligible (both Medicare and Medicaid), you may automatically qualify for LIS, and you might not need to complete the application. You can check with the SSA or your Medicaid office to confirm your eligibility.
________________________________________
Where to Get Help
If you need help completing the online application, you can:
• Call SSA at 1-800-772-1213 for assistance with the LIS application process.
• Visit your local Social Security office or a Medicaid office for in-person support.
________________________________________
This guide will help applicants through the process of filling out the online LIS form (SSA-1020).
Recipients can apply for the Low-Income Subsidy through:
• The Social Security Administration (SSA) website.
• State Medicaid programs (in some cases).
• Direct contact with their Medicare prescription drug plan.
Contact Information for LIS
• Social Security Administration (SSA) Website: www.ssa.gov
• LIS Customer Service: If recipients need assistance, they can contact the SSA at 1-800-772-1213 or 1-800-325-0778 for TTY users.
Responding to emails and following through with deadlines for the Low-Income Subsidy is crucial to maintaining affordable access to prescription drug coverage under Medicare. Missing deadlines or failing to provide the necessary documentation can lead to higher costs and loss of benefits.
To apply for the Low-Income Subsidy (LIS), also known as Extra Help, using Google, follow these steps:
Steps to Apply for LIS via Google:
1. Open Google:
o Go to your preferred web browser and open Google (www.google.com).
2. Search for LIS Application:
o In the search bar, type "Apply for Low-Income Subsidy Medicare Extra Help" or "Apply for LIS Social Security" and press Enter.
3. Find the Official SSA Website:
o Look for the official Social Security Administration (SSA) website in the search results. The correct link will usually be www.ssa.gov or a page with "Social Security" in the URL.
o Click on the link that says "Apply for Extra Help with Medicare Prescription Drug Costs" or something similar.
4. Navigate to the Application Page:
o Once you are on the official SSA website, locate the page dedicated to Low-Income Subsidy (LIS) or Extra Help.
o This page should provide an option to either apply online or download an application form.
5. Apply Online:
o If you choose to apply online, click the button that says “Apply Online” or “Start Your Application”.
o You will be directed to an online form where you can enter your personal details, including income and resources information.
6. Fill in the Required Information:
o Complete the application by filling in details like:
Your Medicare number.
Income and resources information.
Personal details (e.g., name, address, Social Security number, etc.).
Other required information, which may include proof of income, assets, or medical expenses.
7. Submit the Application:
o After completing the form, review the information to ensure it is correct.
o Submit the application online through the SSA website.
8. Check the Status of Your Application:
o After applying, you can check the status of your application by logging into your My Social Security account on the SSA website.
9. Wait for the Decision:
o The SSA will review your application and notify you of your eligibility for LIS. This process can take several weeks.
10. Follow Up:
o If the SSA requests additional documentation or information, be sure to respond promptly to avoid delays or loss of benefits.
________________________________________
Alternatively, Apply by Phone or Mail:
• If you prefer not to apply online, you can also apply by phone by calling the Social Security Administration at 1-800-772-1213.
• You may also request a paper application to be mailed to you.
________________________________________
For more details, you can visit the official SSA website: www.ssa.gov/extrahelp.
To apply for the Low-Income Subsidy (LIS), also known as Extra Help, for recipients of Medicare and Medicaid, you can follow these steps to obtain and complete the application form:
How to Get the LIS Form:
1. Online Application:
o Visit the Social Security Administration (SSA) website directly to apply online for LIS:
Go to www.ssa.gov/extrahelp.
You can apply online through the “Apply Online for Extra Help with Medicare Prescription Drug Costs” link.
Complete the online form and submit it directly to SSA.
2. Paper Application:
o If you prefer to apply on paper, you can request a Low-Income Subsidy (LIS) application form from the SSA. Here's how:
Call 1-800-772-1213 to request the form by phone (TTY 1-800-325-0778 for hearing impaired).
Alternatively, visit your local Social Security office or the nearest Medicaid office to request a paper application form.
3. Download the Form:
o You can also download the LIS application form from the SSA website. Here are the steps:
Visit the SSA website www.ssa.gov.
Search for "Low-Income Subsidy (LIS) application form" or use this direct link: https://www.ssa.gov/forms/ssa-1020.pdf.
Download the SSA-1020 form (Application for Extra Help with Medicare Prescription Drug Plan Costs).
Print and complete the form, then mail it to the SSA or submit it to your local Social Security office.
SSA-1020 Form (Application for Extra Help):
• Form Name: SSA-1020
• Purpose: This is the official form used to apply for the Low-Income Subsidy (LIS).
• Where to Submit: You can mail the completed form to your local Social Security office or submit it online if you apply via the website.
Eligibility for LIS for Medicare and Medicaid Recipients:
• If you are already receiving Medicaid, you may automatically qualify for the full LIS subsidy, and you may not need to submit an application.
• Dual-eligible individuals (those who qualify for both Medicare and Medicaid) often automatically receive LIS, but it is essential to check with the Social Security Administration or your Medicaid office for confirmation.
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