Help With Medication Costs
Low-income subsidy (LIS)
If you have limited income, you may be eligible for extra help from Medicare in paying for prescription medicine. This help is called low-income subsidy (LIS).
Who is eligible for low-income subsidy?
Many people who are eligible for this help don't even realize it's available or that they qualify for it. To be eligible for LIS help, you must:
- Live in the United States or District of Columbia.
- Qualify for Medicare Part A and/or be enrolled in Medicare Part B.
- Have less than $19,140 in annual income or $14,610 in resources (if single).
- Have less than $25,860 in annual income or $29,160 in resources (if married).
To determine your eligibility, Medicare may also look at your assets. Find out what is and is not considered an asset by Medicare.
If you are eligible, what will it cost you per month?
If you get help paying for your Medicare prescription drug plan costs, it will cost less per month than if you didn't get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium.
This table shows you what your monthly plan premium will be if you get extra help. You can also view the printable version of the low-income subsidy summary (PDF).
What to do if you need extra help
Your Keystone First VIP Choice (HMO-SNP) premium includes coverage for both medical services and prescription drug coverages.
If you aren't getting extra help, see if you qualify by calling:
- 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048), 24 hours a day, seven days a week.
- The Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778) between 7 a.m. and 7 p.m., Monday through Friday.
If you have any questions, please call Member Services at 1-800-450-1166 (TTY 711), Monday through Friday, 8 a.m. – 8 p.m., from April 1 to September 30; or seven days a week, 8 a.m. – 8 p.m., from October 1 to March 31.
If you do not qualify for "Extra Help" you may benefit from the Medicare Prescription Payment Plan.
Other assistance
State pharmaceutical assistance programs
A state pharmaceutical assistance program (SPAP) gives prescription drug help and is funded by the state. This program helps members pay for their monthly prescription drug plan premiums, deductibles, copays, and coinsurance. For most programs, members must meet specific income guidelines and additional requirements that vary by state.
Best available evidence (BAE)
The Centers for Medicare & Medicaid Services (CMS) makes it easy to get the latest information about best available evidence (BAE) policies. These policies address cost-sharing for low-income beneficiaries.
Visit the CMS website to learn more about BAE.