New Tools to Improve Access to Medicare Part D Financial Assistance

By Lindsey Copeland: Complete Post through this link…

For many low-income Medicare beneficiaries, the Part D Low-Income Subsidy (LIS) program (also called “Extra Help”) can be a lifeline, helping them afford needed prescription drugs. Under the Inflation Reduction Act (IRA), more enrollees—those with incomes between 135% and 150% of the federal poverty level (FPL)—may qualify for full assistance beginning January 1, 2024.

Currently, LIS has two benefit tiers: full and partial. Each offers different levels of assistance, based on beneficiary income and assets:

  • Full LIS: Medicare enrollees with limited assets ($10,590 in 2023) and incomes below 135% FPL ($19,683 in 2023) are eligible for the full LIS benefit. They pay no Part D premium or deductible, and modest copayments for prescription drugs until they reach the catastrophic threshold ($7,400 in 2023). At that point they face no additional cost sharing.
  • Partial LIS: Medicare beneficiaries with limited assets ($16,660 in 2023) and incomes between 135% and 150% FPL ($21,870 in 2023) can qualify for partial LIS. They may have no or limited Part D premiums (depending on income) and a deductible (up to $104 in 2023). They pay 15% coinsurance until they reach the catastrophic threshold and modest copayments thereafter.

Beginning in January, the IRA eliminates the partial LIS benefit and extends the full subsidy to that cohort. As a result, in 2024, Medicare beneficiaries with incomes below 150% of poverty and assets within the partial LIS limits can qualify for access to Part D plans with no premiums or deductibles and modest co-pays.

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