The Basics about extra help

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What Help is Available?

  • Medicare Savings Programs – State programs that assist individuals, who have limited income, 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 also may 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 8 a.m. to 5 p.m.; Monday through Friday; 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. Medicare beneficiaries receiving LIS may 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. This program is also known as “Extra Help.” For more information about LIS/Extra Help, contact your local Social Security office at 1-800-772-1213 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 from 7 a.m. to 7 p.m.; Monday through Friday. TTY users should call 1-800-325-0778. You also can use the Benefits Eligibility Screening Tool (BEST) on the Social Security website (link opens in new window)  to find out if you are eligible.

“Extra Help” / LIS Premium Summary

The below documents include information about plan premiums, if any, once someone enrolls in CarePlus and qualifies to get the “Extra Help”/Low-Income Subsidy (LIS).

2020 LIS Premium Chart

PDF2020 LIS Premium Chart — English (link opens in new window) 

PDF2020 LIS Premium Chart — Spanish (link opens in new window) 

Low Income Subsidy (LIS) Rider

CarePlus members who qualify for “Extra Help,” which is a program that helps individuals pay for their prescription drug costs, will receive a Low Income Subsidy (LIS) Rider notification 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 still may need to pay.

Also, receiving “Extra Help” will not negatively affect your health plan coverage and benefits.

When should a member receive the LIS Rider?

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

Who sends the LIS Rider?

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

What should a member do if they get this notice?

Keep the LIS Rider notification with your important papers, 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 (PDP) 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 if 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 notification, please call Member Services at 1-800-794-5907; TTY: 711. From October 1 - March 31, we are open 7 days a week; 8 a.m. to 8 p.m. From April 1 - September 30, we are open Monday - Friday, 8 a.m. to 8 p.m. You may always leave a voicemail message after hours, Saturdays, Sundays, and holidays and we will return your call within 1 business day.

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

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 team helps our members 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 the CarePlus Social Services team 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 can guide you through the application process.