Need Help on Rx and Medical?

Need Help on Rx and Medical?

Medicare Savings Program   

Qualification for Medicaid is based on income, and can vary from state to state. Our agents can help you determine if you qualify and help you apply for Medicaid assistance. Just give us a call at  850 266 4005. Below are a few Medicaid terms to help explain the different levels of Medicaid.

Qualified Medicare Beneficiary (QMB): QMB helps pay for Part A and Part B premiums, deductibles, coinsuarnce, and copayments.

Full Medicaid: Covers everything QMB covers and may offer additional benefits not covered by QMB.

Specified Low Income Medicare Beneficiary (SLMB) and Qualified Individual 1 (QI-1): Helps pay for Part B premiums only. No other benefits are offered under these two levels. You will often hear this refereed to as "Partial Medicaid".

 

Low Income Subsidy (LIS) Qualification  

You will often hear Low Income Subsidy refereed to as "Extra Help", and abbreviated as LIS. Simply put, Low Income Subsidy assistance provides finaincial assistance for prescription drugs. Qualifications for Low Income Subsidy Assistance is determined by the Federal Poverty Level (FPL), based on household size, and this can increase the allowable income about $6,000 per year per person over the individual or couple limit.

Individuals earning less than $1,507 per month (18,084/annual) and (13,820 in assets) qualify.   

Couple earning less than $2,030 per month (24,360/annual) and (27,600 in assets) qualify.  

It's important to remember, one would need to qualify for BOTH income and Assets to be eligible for LIS. The below chart shows the amount of assistance on prescription drugs one recieves based off each LIS level. Our agents would be happy to assist you in verifying and/or applying for Low Income Subsidy Assitance.

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LIS Level

Deductible

Initial Coverage Limit

Coverage Gap

Catastrophic Coverage

LIS Level 1

 

$0

$3.35 generic copay

$8.35 brand copay

$3.35 generic copay

$8.35 brand copay

$0

LIS Level 2

$0

$1.25 generic copay

$3.70 brand copay

$1.25 generic copay

$3.70 brand copay

$0

LIS Level 3

$0

$0 generic/brand copay

$0 generic/brand copay

$0

 

LIS Level 4

$83

15% coinsurance

15% coinsurance

$3.35 generic copay

$8.35 brand copay