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Medicaid & Low Income Subsidy Program

Medicaid is a joint Federal and State program that assists people who have limited income and resources with medical costs. Medicaid provides health coverage to millions of low income, disabled and chronically ill seniors, nearly all of whom are also enrolled in Medicare.

Medicaid programs vary state by state, but most of your health care costs are covered if you qualify for both Medicare and Medicaid. This type of coverage is often referred to as “Dual Eligible.”  Medicaid enrollees may get help paying for their premiums and out-of-pocket medical expenses from Medicaid.

Medicaid also covers additional services beyond those provided under Medicare, including nursing facility care beyond the 100 day limit or skilled nursing facility care that Medicare covers, help with prescriptions drugs, eyeglasses and hearing aids. Services covered by both programs are first paid by Medicare, with Medicaid filling in the difference up to the state’s payment limit.

If you qualify for Medicaid, you automatically qualify for the Medicare Part D “Extra Help” program that may lower the cost of your prescription drugs.

The Federal Government maintains a program called the Low Income Subsidy Program or LIS. This program, oftentimes referred to as Extra Help, assists those who have a limited income and resources to pay for their Part D prescription drug costs. The amount of help a beneficiary receives from the program depends on their income, with beneficiaries receiving either a full subsidy or a partial subsidy.  Those who qualify for Extra Help may pay:

  • No premiums
  • No deductibles
  • Protection from the Donut Hole (gap)

If you are on Medicare through age or disability and you would like to see if you qualify for Medicaid or Extra Help, we can assist you with the application process.

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