How to Qualify for Extra Help/Low-Income Subsidy (LIS) with Part D Costs

Eligibility for Extra Help/LIS for 2024

You will be automatically enrolled in a drug plan with the Extra Help/Low-Income Subsidy (LIS) program for 2024 if you qualify for Medi-Cal or a certain type of Medicare Savings Program (Qualified Medicare Beneficiary, Specified Low-Income Medicare Beneficiary or Qualified Individual program). The chart below explains what you will pay for your Part D coverage depending on the Medi-Cal and/or Medicare Savings Program (MSP) program for which you qualify, assuming you are enrolled in a benchmark plan.

You have…
Your Assets Are at or Below…You Pay
Medi-Cal without a Share of Cost (SOC). This includes the Aged & Disabled Federal Poverty Level program (A&D FPL).

Medi-Cal with a SOC and your SOC is met in any one month.

No resource limit as of January 1, 2024


  • No monthly premium
  • (for a benchmark plan)
  • $0 deductible
  • Copayments of $1.55/generic and $4.60/brand name. No copayments during catastrophic coverage.
If SOC is met before July 1, the Extra Help applies until the end of the current year. If SOC is met between July 1 and Dec 31, the Extra Help remains through Dec of following year.

Note: If you have Medi-Cal and are living in a nursing home or are receiving Medi-Cal Home and Community Based Services (HCBS), you will have no drug copayments.

a Medicare Savings Program, such as Qualified Medicare Beneficiary (QMB), Specified Low-Income Beneficiary (SLMB) or Qualified Individual (QI) program.
No resource limit as of January 1, 2024

  • No monthly premium
  • (for a benchmark plan)
  • $0 deductible
  • Copayments of $4.50/generic and $11.20/brand
  • name. No copayments during catastrophic coverage.

If you do not meet the qualifications in the chart above, you can self enroll1 for the Extra Help/LIS through the Social Security Administration if you meet the qualifications in the chart below. You will not automatically be enrolled in the Extra Help program.

Your Income Is Equal to or Below2… Your Assets Are at or Below3You Pay
150% of the FPL:

 

  • Single: $1,903/mo.
  • Couple: $2,576/mo.
Single: $17,220

Couple: $34,360

  • No monthly premium (for a benchmark plan)
  • $0 annual deductible
  • copayments up to $4.50/generic and $11.20/brand-name during catastrophic coverage

1You must also enroll in a Medicare Part D drug plan if you qualify for Extra Help/LIS.
2 When determining eligibility for this program, $20 of one’s income is disregarded. Therefore, $20 has been added to the limits above to more closely reflect the eligibility levels.
3 Asset limit includes the allowed amount for burial expenses: Single, $1,500; Couple, $3,000. Note that for LIS, this exempt $1,500 per person for burial expenses can be in a bank account.