LIS Premium Summary Information and Chart

If you qualify for extra help, the low-income subsidy (LIS) is paying for your Medicare prescription drug coverage costs, your Medicare prescription drug plan’s monthly premium, and deductibles (if applicable). In addition, your prescription co-payments could be lower. To see your plan specific premiums, deductibles, copayments and co-insurance amounts please refer to the 2012 Summary of Benefits.

If you qualify for extra help, you pay $0 or a reduced monthly Part D premium. If you continue to qualify for the same amount of extra help in 2012, the table below tells how much you will pay for a monthly premium. (This doesn’t include any Medicare Part B premium you may have to pay.) Premiums listed here are for both medical services and prescription drug benefits.

 

Your level of extra help CareSource Advantage Monthly Premium
100% $0
75% $0 
50% $0
25% $0

 

 

 

 

H0141_MIMSNP562
CMS Approved 9/29/2011