Jack's Blog on Medicare Plan Choices

Let’s discuss the Medicare Low Income Subsidiary program.  The program is called LIS for short and is also known as “Extra Help.”

What is it:

The LIS program helps people with limited income and resources pay for their Medicare Part D prescription drug costs, including premiums, deductibles, and copayments.

Who runs it:

LIS is administered by the Social Security Administration (SSA) in collaboration with the Centers for Medicare & Medicaid Services (CMS).

2025 Eligibility:

Beneficiaries must be enrolled in Medicare Part D (Prescription Drug Plan) or a Medicare Advantage Plan that includes drug coverage.

For 2025, the income threshold is set at 150% of the Federal Poverty Level (FPL), with a resource limit of $17,220 for individuals and $34,360 for couples.  Let’s break that down by your monthly income.

Individual:      $1435 per month

Couple:          $2863 per month

These limits include a $1,500 per person burial expense allowance. More on this below..

Levels of Assistance:

• Full Subsidy: For those with the lowest income, covering almost all Part D costs.
• Partial Subsidy: For those with income closer to the eligibility limit, covering a portion of the Part D costs.

Application Process

• SSA Application: People can apply for Extra Help through the SSA, either online, over the phone, or in person. The SSA reviews applications and determines if applicants meet the eligibility criteria.

• Automatic Qualification: Some individuals, such as those who already receive Medicaid, Supplemental Security Income (SSI), or a Medicare Savings Program, may automatically qualify for Extra Help and do not need to apply separately.

• Please note that I help all my customers apply for LIS when their income levels warrant it.  Usually, we talk over the phone while I enter the data in the online application.

Burial Allowance:

• The “$1,500 burial expense allowance” is a rule that lets people set aside up to $1,500 specifically for burial or funeral costs without it counting against them.
• A couple could set aside up to $3,000.
• Why It Matters. This money doesn’t count as part of their assets, making it easier for low-income people to qualify for financial help with things like prescriptions and medical costs
• In other words, you’re allowed to keep a small amount of money for funeral costs without it affecting your eligibility for help.

Here is my disclaimer.  I gather most of my information from Medicare.gov and CMS.gov and to the best of my knowledge, it is accurate.  I also used the Social Security website at SSA.GOV for this article. Please use this information as a guideline.

Before choosing an Advantage or Supplement plan, ensure you have a thorough understanding of Medicare itself. When it’s time to explore your options, don’t fall for a sales pitch from a single company or an agent representing only one provider.

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