Resources to Help Medicare Enrollees Preserve Financial Assistance for Drug Costs

Source: National Center On Law & Elder Rights

September 20, 2024

The Low-Income Subsidy, known as LIS or “Extra Help” is a program administered by the Social Security Administration (SSA) that provides financial assistance with Medicare Part D prescription drug costs including premiums and co-pays.

Each year in September, some individuals with the LIS will receive notices from Medicare informing them that their LIS is ending at the end of the year and that they will need to reenroll with SSA to continue to receive financial assistance with their Medicare drug costs.

These notices are specific to individuals who were deemed eligible for LIS because they were eligible for Medicaid or a Medicare Savings Program (MSP). When these individuals lose their Medicaid or MSP eligibility—as happened at high rates in 2023 and 2024 due to the Medicaid unwinding—they also lose their LIS eligibility. Because of the way LIS works, a person typically loses LIS many months after they lose Medicaid or MSP.

Individuals who receive notices this month are those who lost Medicaid coverage between July 1, 2023 and, June 30, 2024. They will remain LIS eligible through December 31, 2024, but will lose coverage starting January 1, 2025, unless they reapply for LIS through the Social Security Administration or reestablish Medicaid eligibility. The financial eligibility criteria for LIS are broader than those for Medicaid. Accordingly, even if someone is no longer eligible for Medicaid, they may still qualify for LIS.

Legal assistance, aging services, and elder rights professionals working with older adults can help ensure that older adults do not lose their critical coverage. Individuals who receive a notice from Medicare about their LIS ending should act now and reapply for LIS coverage as soon as possible to continue to receive assistance with Part D drug costs in 2025. Individuals not eligible for LIS may want to consider choosing a different Part D plan that is more affordable.

Additional Resources for Advocates:

• Justice in Aging: Medicare Part D Low-Income Subsidy, Medicaid, and the End of the Public Health Emergency: Tips for Advocates
• NCLER: Are Your Clients Missing Out on Enrollment in the Medicare Low-Income Subsidy?
• NCLER: Your Low-Income Clients May be Overpaying for Part D Prescription Drug Coverage
• NCLER Training: Medicare Savings Programs