2015 Medicare Advantage Plans That Offer a $0 Drug Premium with Full Low-Income Subsidy (LIS)
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1 2015 Medicare Advantage Plans That Offer a $0 with Full Low-Income Subsidy (LIS) ( County and Northeastern Illinois) County Name Plan Name Plan s Health and Part B premium Aetna Medicare Value Aetna Medicare Aetna Medicare Value Aetna Medicare If the plan has a drug premium or deductible that is more than $0, then CMS will cover this amount for individuals with full LIS Plan H (HMO) $3.10 $10.90 $0.00 Plan H (PPO) $0.00 $0.00 $0.00 H Premier H H (HMO) $0.00 $16.30 $ Rx H (HMO) $0.00 $14.40 $ Value H H
2 County Name Plan Name Plan s Health H Premier Grundy UnitedHealthcare H (HMO) $0.00 $16.30 $ (Regional PPO) $92.80 $30.20 $320 H (HMO) $0.00 $0.00 $0.00 AARP MedicareComplete Focus H (HMO) $0.00 $0.00 $ H Premier H (HMO) $0.00 $16.30 $ HumanaChoice H (HMO) $23.00 $0.00 $0.00 HumanaChoice R (PPO) $92.80 $30.20 $ Wellcare Value H (HMO-PPO) $0.00 $0.00 $0.00 Rx H (HMO) $0.00 $14.40 $320.00
3 County Name Plan Name Plan s Health Kankakee Value H1416- Kankakee Rx H Kankakee Coventry Health Care Advantra Kendall of Illinois, Coventry Health Care Advantra Value Kendall of Illinois, Kendall Kendall Lake Lake 009 (HMO) $0.00 $14.40 $ H (Local PPO) $25.00 $4.00 $0.00 H (Local PPO) $14.00 $0.00 $0.00 H (HMO) $23.00 $0.00 $0.00 Alliance of Illinois H (HMO) $0.00 $0.00 $0.00 H (HMO) $23.00 $0.00 $0.00 H Premier H H (HMO) $0.00 $16.30 $ Alliance of Illinois
4 County Name Plan Name Plan s Health *Please note this chart is not a comprehensive list of Medicare Advantage plans with drug coverage (MA- PD) offered in This chart lists only the MA-PD plans that offer a $0 premium with full LIS/Extra Help. For a complete list of plans available by area, please visit What is the Low-Income Subsidy? The Low-Income Subsidy, also referred to as LIS or Extra Help is a federal prescription drug assistance program to help people with Medicare pay for their prescription drug costs. The Social Security Administration (SSA) processes LIS applications and determines eligibility and the Centers for Medicare and Medicaid Services (CMS) administers the program. How does the Low-Income Subsidy (LIS) work with Medicare Advantage plans? The LIS program provides the following benefits: Assistance with all or a portion of the monthly drug premium and deductible Low cost prescription drug co-payments at the pharmacy Part D donut hole (coverage gap) is eliminated Beneficiary is responsible for: Plan s Health (covers medical and hospital benefits, and may cover extra benefits not usually covered by Original Medicare such as vision or dental) Part B (unless enrolled in a Medicare Savings Program) Medicare Advantage co-pays or co-insurance amounts for each time a health service is used (e.g., primary care doctor co-pay or inpatient hospital stay co-pay) Prescription co-payments Full LIS: between $1.20 and $6.35 for each 30-day supply filled Partial LIS: $2.55, $6.35 or up to 15% coinsurance for each 30-day supply filled Note: People who have both Medicare and Medicaid (called dual eligibles) and reside in a longterm care facility pay $0 co-pay for their prescription drugs. In addition, individuals who receive certain home and community based services will also pay $0 co-pays for their drugs. How do I apply for LIS? Value H Rx H (HMO) $0.00 $14.40 $320.00
5 You may apply for LIS by submitting an application online through Social Security s website at or by mailing in a paper application. Please contact Social Security at (800) to request an application Low-Income Subsidy (LIS) Income and Asset Limits (2015 income and asset limits will be posted in early 2015 once the federal poverty levels are announced) Full Low-Income Subsidy Individual Couple Income $1,314 monthly $1,770 monthly Asset $8,660* $13,750* Partial Low-Income Subsidy Individual Couple Income $1,460 monthly $1,967 monthly Asset $13,440* $26,860* * Resource limits include $1,500 per person burial expenses
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