The Basics about extra help

What Help is Available?

  • Medicare Savings Programs – This program provides help from Medicaid paying Medicare costs including Medicare premium(s), deductibles, copayments, and/or coinsurance if you meet certain conditions. 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; 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 people 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 open Monday, Tuesday, Thursday, and Friday 9 a.m. – 4 p.m. and Wednesday 9 a.m. – 12 p.m. 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 Social Security at 1-800-772-1213 (TTY: 1-800-325-0778), or contact your local Social Security office. 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.

2017 LIS Premium Chart

PDF2017 LIS Premium Chart - English (link opens in new window) 

PDF2017 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 that helps cover the cost of their prescription drug coverage, 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. Your membership in our plan will not be affected by you 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.This information is available for free in other languages. Please call our Member Services number at 1-800-794-5907. TTY users should call 711.

We have free interpreter services to answer any questions you may have about our health or drug plan. To get an interpreter, just call us at 1-800-794-5907. Someone who speaks your language can help you. This is a free service. TTY users should call 711.

How to get Extra Help with prescription drug costs

  • Some people 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. The government has already contacted these Medicare beneficiaries about getting Extra Help, but they still need to choose a prescription drug plan.
  • 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 government 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.

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