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Limited Income and Resources

Guidance for Medicare providers with information on the Low Income Subsidy (LIS) and how CMS works with partners to find and enroll people who may qualify for the LIS, and encourages local organizations to tell people in their communities about it.

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: November 21, 2019

What's the Low Income Subsidy (LIS)?

The Low Income Subsidy (LIS) helps people with Medicare pay for prescription drugs, and lowers the costs of Medicare prescription drug coverage.   

How can I help people get the LIS?

We work with our partners to find and enroll people who may qualify for the LIS, and we encourage local organizations to tell people in their communities about it.

Who might need help with their LIS? 

There are 4 groups of people who already have the LIS, but may need some help to keep it or to understand that their LIS is changing. We send them targeted notices on colored paper when there are changes to their LIS.

1. People who won’t automatically be eligible for the LIS

Each September, we mail a notice (CMS Publication No. 11198) (PDF) on gray paper to people who’ll no longer automatically get the LIS. This notice is a LIS application, and it includes a postage-paid pre-addressed envelope. These people may still qualify for the LIS, but they will need to send in a new application. The gray notice:

  • Tells the person why they no longer automatically qualify for the LIS
  • Encourages them to fill out and send in a LIS application

2. People who’ll have a change to their LIS co-payment

In early October, we mail a notice (CMS Publication No. 11199) (PDF) on orange paper to people who’ll qualify for extra help, but will have a change to their co-payment.

3. People who’ll be reassigned to a new plan

In early November, we mail a notice on blue paper (CMS Publication No. 11208) (PDF) to people who qualify for the LIS, but will be reassigned to a new prescription drug plan starting on January 1st.  

We automatically reassign people who:

  • Qualify for the full (100%) premium subsidy
  • Are in a prescription drug plan that’s raising the premium above the low-income premium amount
  • Were enrolled in their current plan by CMS

We’ll also automatically reassign people who qualify for the LIS, if their prescription drug plan leaves the Medicare Program.

4. People who chose their plan

In early November, we mail a notice (CMS Publication No. 11267) (PDF) to people:

  • Whose premium cost will increase, but we’re not automatically reassigning to a new plan, because they chose and joined their plan.
  • Who qualify for the full (100%) premium subsidy, but are in a plan that’s increasing their premium amount so it’s more than the standard low-income premium subsidy amount.

This notice tells people about the increase in their drug plan premium costs, and explains their options to stay in their plan or join another plan (including plans they won’t pay a monthly premium for).

Where can I learn more about the LIS?

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.