Certain low-income individuals covered by Medicare are eligible for a program called Low Income Subsidy (LIS), also known as Extra Help. LIS provides assistance paying for Medicare prescription drug plans (Part D) premiums and co-pays. To qualify for LIS, individuals must be covered by a Part D plan or Medicare Advantage plan with drug coverage. There may be a gap in time between a person being granted LIS coverage and the time when Part D coverage takes effect. To assist with drug costs during this gap, the LI NET (Low Income Newly Eligible Transition) program provides temporary drug coverage that lasts about 2 months. Note that if you do not enroll in a Part D plan, you will be auto-enrolled by Medicare. LI NET pays for all drugs covered under Part D and can be used at any pharmacy. Once your Part D plan becomes effective, LI NET will be discontinued and only those drugs that are in your plan's formulary will be covered.
If you are covered by LI NET, you will receive a welcome letter from Medicare or Social Security including the effective date for your coverage, a membership card, and instructions. If you need a prescription, take all this information to the pharmacy. The pharmacist will know how to process the claim for coverage. Your level of assistance will determine co-pays. If you incurred out of pocket expenses on covered drugs while eligible for LI NET, you can apply for reimbursement.