Low income subsidy
If you qualify for extra help with your Medicare prescription drug plan costs, your premium and costs at the pharmacy will be lower. When you join one of our plans, Medicare will tell us how much extra help you are getting. Then we will let you know the amount you will pay.
The following chart outlines the premium amounts based on the various low income subsidy levels. If you are not getting this extra help, you can see if you qualify by calling Social Security at 1-800-772-1213 (TTY users should call 1-800-325-0778) or visit
www.socialsecurity.gov on the Web.
| 2010 Monthly Premiums |
Conventional Plan $57.70/month |
Premier Plan $92.10/month |
Premier Plan Plus $112.00/month |
| 25% Low Income Subsidy (LIS) |
N/A
|
You pay $83.90* |
You pay $103.10* |
| 50% Low Income Subsidy (LIS) |
N/A
|
You pay $75.70* |
You pay $94.20* |
| 75% Low Income Subsidy (LIS) |
N/A
|
You pay $67.60* |
You pay $85.30* |
| 100% Low Income Subsidy (LIS) |
N/A
|
You pay $59.40* |
You pay $76.40* |
* The premiums listed above include both medical service and prescription drug benefits. These premiums do not include any Medicare Part B premium you may have to pay.
See also Centers for Medicare and Medicaid Services (CMS) Best Available Evidence Policy at
CMS Best Available Evidence Policy.
Last modified: October 1, 2009
H3811_MA4001 CMS approved 11.2009