Low-Income Subsidy (LIS) / Extra Help

If you’re on Medicare with a low income, you may qualify for a subsidy to help with the costs of healthcare and medications. Even those who don’t qualify for Medicaid in Florida and Texas may be eligible for a Medicare savings program or subsidy.

However, if you qualify for Medicaid, that automatically makes you eligible to receive Extra Help. In today’s post, Lacayo Group Insurance will answer common questions about Medicare and low-income subsidy benefits.

How Do You Get Extra Help?

If you have Medicare and get ANY of the following, you will get the Extra Help program:

  • Full Medicaid coverage
  • Help from your state Medicaid program paying your Medicare Part B premiums
  • Supplemental Security Income (Ssi) benefits

Those who don’t qualify automatically can apply at any time.

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Who Qualifies for Extra Help?

In 2021, you may be eligible if you have up to $19,320 in annual income ($26,130 for a married couple) and up to $14,790 in resources ($29,520 for a married couple). What do we mean by resources?

Stocks, bonds, and money in a checking or savings account are resources that count to see if you qualify for Extra Help.

Your home, one car, a burial plot, furniture, and other household and personal items are resources that do NOT count.

How Much Do You Get Per Year?

Social Security estimates the Extra Help to be worth around $5,000 per year. To qualify, you must be on Medicare, have limited income and resources, and live in one of the 50 states of the District of Columbia.

Medicare recipients can use this money to pay their monthly premiums, yearly deductibles, and copayments associated with Medicare Part D (known as prescription drug coverage).

After You Qualify

Once you qualify, you’ll get Extra Help for as long as you meet the income and resource limits for that year.

On that note, if you automatically qualify in 2021, that does not mean you will automatically qualify for Extra Help in 2022. Changes in your income or resources may cause you to no longer qualify for the program.

What Other Savings Programs Exist?

Those who meet the criteria may qualify for one of the following programs:

  • Qualified Medicare Beneficiary (QMB) Program: Helps pay for your Medicare Part A premiums, Part B premiums, deductibles, coinsurance, and copayments.
    • Individual monthly income limit in 2021: $1,094*
    • Married couple monthly income limit: $1,472*
  • Specified Low-Income Medicare Beneficiary (SLMB) Program: Helps pay Medicare Part B premiums for those who have Part A and limited income and resources.
    • Individual monthly income limit in 2021: $1,308*
    • Married couple monthly income limit: $1,762*
  • Qualifying Individual (QI) Program: Like the SLMB, this program helps pay Medicare Part B premiums for those who have Part A and limited income and resources. You have to apply each year for QI benefits. It’s first-come, first-served. But if you qualify for Medicaid, you can’t get QI benefits.
    • Individual monthly income limit in 2021: $1,469
    • Married couple monthly income limit: $1,980
  • Qualified Disabled and Working Individuals (QDWI) Program: Helps pay the Part A premium. It mostly applies to a working disabled individual under 65.
    • Individual monthly income limit in 2021: $4,379
    • Individual monthly income limit in 2021: $5,892

*If your income is a little higher than the limits listed above, it’s still worth applying.

If you qualify for the QMB, SLMB, or QI program, you’re automatically eligible for Extra Help paying for your drug coverage.

How to Apply

If you have or are eligible for Part A, your income is at or below the limits listed above, and you have limited resources, talk to someone in Florida. You can call the Florida Medicaid program to see if you qualify for a Medicare Savings Program.

For more information, you can also contact us at Lacayo Group Insurance.