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Limited Income and Resources


Limited Income and ResourcesWhat’s the Low-Income Subsidy (LIS)?

Lowering prescription drug expenses for those on Medicare is made possible by the Low-Income Subsidy (LIS).

How can I help people get the LIS?

People who may be eligible for the LIS can be found and enrolled by working with our partners, and we encourage local organizations to spread the word about it.

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medicare prescription drug coverageWho might need help with their LIS? 

If you have the LIS but need help keeping it or understanding why it’s changing, there are four categories of people. When there are updates to their LIS, we send them targeted notices on colored paper.

1. People who won’t automatically be eligible for the LIS

People who will no longer receive the LIS automatically are sent a notice (CMS Publication No. 11198) (PDF) in the mail every September. The enclosed pre-addressed, postage-paid envelope is part of the LIS application process. The LIS may still be available to those who submit a fresh application. The notice in gray:

  • Explains to the individual why they are no longer eligible for the LIS.

  • A LIS application application is encouraged to be filled out and sent in

2. People who’ll have a change to their LIS co-payment

Those who will be eligible for more assistance, but whose co-payment will be changing, will get an orange-colored notice (CMS Publication No. 11199) (PDF) in the mail around the beginning of October.

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3. People who’ll be reassigned to a new plan

A notice on blue paper (CMS Publication No. 11208) (PDF) is mailed in early November to those who qualify for the LIS but will be switched to a new prescription drug plan beginning on January 1st.

People are automatically reassigned if they are found to be:

  • To be eligible for the maximum (100%) premium subsidy, you must

  • A prescription medication plan’s premiums are higher than those for people with low income.

CMS automatically enrolled them in their current health insurance plan.

Also, if their prescription drug coverage exits the Medicare Program, we’ll automatically allocate those who qualify for LIS.

4. People who chose their plan

We send out a notification (CMS Publication No. 11267) (PDF) in early November, informing recipients of the following:

  • Whose premium cost will increase, but we’re not automatically reassigning to a new plan, because they chose and joined their plan.

  • While receiving the maximum (100 percent) subsidy, they are in a plan that raises their premiums above the usual low-income subsidy rate.

An explanation of how much their drug plan premiums will go up, as well as the option to switch to a different plan (including one for which they won’t have to pay a monthly premium), is included in this message.

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