Eligibility for Extra Help/LIS for 2020
You are automatically enrolled in a drug plan with the Extra Help/Low-Income Subsidy (LIS) program for 2019 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.
| Your Income Is… (Note: does not include the $20 disregard) | Your Assets Are at or Below…1 | You Pay |
|---|---|---|
Under 100% of the federal poverty level (FPL):
|
Single: $7,860
Couple: $11,800 |
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. |
More than 100% but less than 135% of the FPL:
|
Single: $7,860
Couple: $11,800 |
|
More than 135% of the FPL and you met your Medi-Cal share of cost (SOC) any single month since July 1, 2019:
|
Single: $2,000Couple: $3,000 |
|
1 Asset limit does not include the allowed amount for burial expenses: Single, $1,500; Couple, $3,000. Note that for Medi-Cal, this $1,500 per person for burial expenses cannot be in a bank account. It must be invested in a burial policy.
If you do not meet the qualifications in the chart above, you can apply1 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 LIS program.
1You must also enroll in a Medicare Part D drug plan if you qualify for Extra Help/LIS.
2 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.