The most readily available assistance program for Medicare is the Part D Extra Help program. This pays for 85% or more of the costs that come with Medicare’s Prescription Drug Program (Part D). It is sometimes called the Low Income Subsidy program or LIS.
Extra Help has higher income and asset limits than programs such as Medicare Savings Programs and Medicaid. LIS offers assistance to beneficiaries by helping them pay a reduced amount for Medicare-covered prescriptions at the pharmacy. A beneficiary can be enrolled in a stand-alone Prescription Drug Plan or a Medicare Advantage plan with drug coverage. There are different levels of assistance that vary by income and asset levels. The lower the income and resource, the greater the help.
| Program | Monthly Income | Resources | What it pays for | How to Apply |
| Qualifying Individual- 1 (QI-1) (Subject to Federal Funding) | Single $1,426 Couple $1,923 | Single $7,730 Couple $11,600 | Medicare Part B premiumYou are auto enrolled in Part D Extra Help, which lowers the cost of premiums, deductibles, copays, coinsurance, and eliminates coverage gaps. | Local Department of Family Support Office Download form: www.dss.mo.gov/fsd MO HealthNet Application |
| Specified Low-Income Medicare Beneficiary (SLMB) | Single $1,269 Couple $1,711 | Single $7,730 Couple $11,600 | Medicare Part B premiumYou are auto enrolled in Part D Extra Help, which lowers the cost of premiums, deductibles, copays, coinsurance, and eliminates coverage gaps. | Local Department of Family Support Office Download form: www.dss.mo.gov/fsd MO HealthNet Application |
| Qualified Medicare Beneficiary (QMB) | Single $1,061 Couple $1,430 | Single $7,730 Couple $11,600 | Medicare Part A premiums, if applicableMedicare Part B premiumsCo-insurance and deductibles for Parts A & BCost-sharing for Medicare AdvantageYou are auto enrolled in Part D Extra Help, which lowers the cost of premiums, deductibles, copays, coinsurance, and eliminates coverage gaps. | Local Department of Family Support Office Download form: www.dss.mo.gov/fsd MO HealthNet Application |
Enrollment in Extra Help is done through the Social Security Administration. An application can be submitted online or a paper application can be requested by contacting CLAIM or visiting your local SSA office. Click here for help finding your local Social Security office.
You automatically get Extra Help if you:
have both Medicare and Supplemental Security Income (SSI), or
have both Medicare and Medicaid.
© 2019 CLAIM. All Rights Reserved.
Website design and development by Pixel Jam Digital