The Basics about extra help

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What Help is Available?

  • Medicare Savings Programs – These are state programs that assist individuals with limited income paying with their Medicare costs. The names of these programs may vary by state. The state can help individuals paying for Medicare premiums. In some cases, Medicare Savings Programs may also pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles, coinsurance, and copayments if certain conditions are met. For information about this program and to see if you qualify, call the Florida Department of Children and Families at 1-866-76-ACCESS or 1-866-762-2237; Agents available 8am to 5pm Mon-Fri; TTY users should call 711 or you may apply online at www.myflorida.com/accessflorida (link opens in new window) .
  • Low Income Subsidy (LIS) – A program to help individuals pay for Medicare Prescription Drug costs, that it is also called “Extra Help”. Medicare beneficiaries receiving LIS may be able to qualify for assistance in paying for their Part D monthly premium, annual deductible, coinsurance, and copayments. The amount of subsidy depends on the individual's income compared to the Federal Poverty Level and resource limitations set by the Social Security Act. For more information about LIS/Extra Help, contact your local Social Security office at 1-800-772-1213. They are open from 7 a.m. to 7 p.m.; Monday through Friday. TTY users should call 1-800-325-0778 or call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.
  • Programs of All-Inclusive Care for the Elderly (PACE) – A combination of medical, social, and Long-term Care services available only in states that choose to offer it under Medicaid. Eligibility requirements vary from state to state. For Florida, contact the Department of Elder Affairs (link opens in new window) .
  • Supplemental Security Income (SSI) benefits – Help for people who are disabled, blind, or over age 65 and have limited financial resources. SSI is NOT the same as Social Security benefits. For more information, call the Social Security office at 1-800-772-1213. They are open from 7 a.m. to 7 p.m.; Monday through Friday. TTY users should call 1-800-325-0778. You can also use the Benefits Eligibility Screening Tool (BEST) on the Social Security Website to find out if you're eligible.

Extra Help / LIS Premium Summary

The purpose of these documents is to inform beneficiaries of what their plan premiums, if any, will be once they are eligible with CarePlus and qualify to receive the Extra Help/Low-Income Subsidy (LIS). Please click the link below to access the LIS Premium Summary information for the corresponding calendar year.

2018 LIS Premium Chart

PDF2018 LIS Premium Chart - English (link opens in new window) 

PDF2018 LIS Premium Chart - Spanish (link opens in new window) 

Low Income Subsidy (LIS) Rider

If a member qualifies for Extra Help, which is a program to help individuals pay for their prescription drug costs, they will get a Low Income Subsidy (LIS) Rider from CarePlus informing them how much help they will get with paying their monthly drug plan premium, deductible, and prescription drug copayments. The monthly plan premium does not include any Medicare Part B premium that a member may still need to pay.

As a member of CarePlus, you will receive the same coverage as someone who is not getting Extra Help. The membership in our plan will not be affected by receiving Extra Help.

When should a member receive the LIS Rider?

A member will receive the LIS Rider upon enrollment and each September thereafter informing them of changes occurring for the upcoming year. LIS Riders may be sent throughout the year, if updates occur to the member's LIS Level.

Who sends it?

CarePlus will send the LIS Rider to the member, if the member qualifies for Extra Help.

What should a member do if they get this notice?

Keep the LIS Rider with your Evidence of Coverage (EOC), so you can refer to it if you have questions about your costs.

Medicare or the Social Security Administration will periodically review a member's eligibility to make sure the member still qualifies for Extra Help with Medicare prescription drug plan costs. Eligibility for Extra Help might change if there is a change in the member's income or resources, if a member gets married or becomes single, or the member becomes ineligible for Medicaid benefits. The member will be notified if her/his status changes.

If you have any questions about your LIS Rider, please call Member Services at 1-800-794-5907; from 8 a.m. to 8 p.m., 7 days a week. From February 15th to September 30th, we are open Monday-Friday from 8 a.m. to 8 p.m. TTY users should call 711.

You must continue to pay your Medicare Part B premium. The Part B premium may be covered through your State Medicaid Program.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply.

Benefits, premiums, and/or member cost-share may change on January 1 of each year. ATTENTION: If you speak Spanish, language assistance services free of charge, are available to you. Call 1-800-794-5907 (TTY: 711).

ATENCIÓN: Si usted habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-794-5907 (TYY: 711).

How to get Extra Help with prescription drug costs

  • Some individuals qualify for assistance with Medicare costs automatically because they participate in Medicare and other programs, such as Medicaid, Medicare Savings Programs, and Supplemental Security Income (SSI) benefits.
  • Millions of others qualify because of limited income and resources, but they need to apply. The Social Security Administration is accepting applications by mail and on their website at www.ssa.gov (link opens in new window) .
  • Applying for Extra Help is NOT the same as joining a prescription drug plan. Whether you qualify for Extra Help or not, you must also enroll in a plan to get prescription drug coverage.

The CarePlus Social Services department assists our members to apply for public assistance through a variety of state and federal programs. If you are interested in receiving assistance or if you have questions and would like additional information, please contact CarePlus' Social Services department at 1-855-392-3900. We are open Monday – Friday from 8 a.m. to 5 p.m. TTY users should call 711. One of our specially-trained Social Services associates will then contact you and guide you through the application process.