EXTRA HELP FOR PRESCRIPTION DRUG COSTS

Do you qualify for extra help with your prescription drugs?

Medicare provides "extra help" to pay prescription drug costs for people who have limited income and resources. Resources include your savings and stocks, but not your home or car. If you qualify, you will get help paying for any Medicare drug plan's monthly premium, yearly deductible, and prescription co-payments. If you qualify, this extra help will count toward your out-of-pocket costs.

People with limited income and resources may qualify for extra help one of two ways:

1. You automatically qualify for extra help and don't need to apply, or
2. You manually apply and then qualify for extra help.

The amount of extra help you get will depend on your income and resources.

If you are not already receiving this additional assistance, you should contact 1-800-MEDICARE (24 hours a day, 7 days a week).

Refer to your Evidence of Coverage for additional details on "extra help"/Low Income Assistance (LIS). The LIS premium chart will show you what your monthly plan premiums would be if you get extra help.

To view the LIS premium chart, select your state and county below, then click OUR 2018 PLANS. Click View Details for the plan you are interested in. The LIS premium chart is on the right side of the page.

Note:
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, & restrictions may apply. Benefits may not be available for all plans. You must continue to pay your Medicare Part B premiums.

Best available evidence

The Centers for Medicare & Medicaid Services (CMS) requires that all plan sponsors accept evidence presented by a Medicare beneficiary that he or she is eligible for extra help/ Low Income Subsidy (LIS) even if Medicare records show otherwise. Once a beneficiary submits the Best Available Evidence to Cigna-HealthSpring, we will request that CMS update the beneficiary's LIS status in the CMS system.

Acceptable forms of Best Available Evidence include:

  • A copy of your Medicaid card (if you have one).
  • A copy of a state document that shows you have Medicaid.
  • A print-out from a state electronic enrollment file or from your state's Medicaid systems that shows you have Medicaid.
  • A screen print from the State's Medicaid systems showing Medicaid status.
  • Any other document from your state that shows you have Medicaid.
  • A document from your state that shows you have Medicaid and are getting home- and community-based services.
  • Social Security Administration (SSA) Award Letter.
  • An application (SSA publication HI 03094.605) filed by Deemed Eligible confirming that the beneficiary is "automatically eligible for extra help". See a sample notice for application filed here.

Refer to CMS.gov for more information on BAE Policy by CMS.

Medicare and Social Security Info: