Do I Qualify for Extra Help?
LOW INCOME SUBSIDY (LIS)
You may be able to get Extra Help from the government for your Medicare Advantage plan with prescription drug coverage.
You may be eligible for help paying for some or all of your prescription drug costs, based on guidelines set by the federal government. You can apply for this help through the Social Security Administration or a state Medical Assistance Office. The amount of assistance you receive, if any, will depend on your income and resources, and is determined by the federal government.
If you aren't getting Extra Help, you can see if you qualify for Extra Help to pay for your prescription drug costs. If eligible, Medicare could pay for up to one-hundred (100) percent of drug costs including monthly prescription drug premiums, annual deductibles, and coinsurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don't know it.
To see if you qualify for Extra Help, call: (800) 633-4227. TTY users should call (877) 486-2048, 24 hours a day, 7 days a week; the Social Security Office at (800) 772-1213 between 7:00AM and 7:00PM, Monday through Friday. TTY users should call (800) 325-0778; or your state Medicaid office.
For the Medicare program's policy on evidence of eligibility for low income subsidy, visit the CMS website's Best Available Evidence page.
2023 Premium Subsidy Tables for Those Who Qualify for Extra Help
If you know you qualify for or are already receiving help to pay for your Medicare prescription drug plan, learn how much you will pay for your monthly premium as a member of a Medicare Advantage plan. The premiums listed in the table below include coverage for both medical services and prescription drug coverage.
| Your Extra Level of Help | Your Monthly Premium* | |||||||
|---|---|---|---|---|---|---|---|---|
| Generations Classic Rewards (HMO) | Generations Classic Plus (HMO) | Generations Chronic Care (HMO C-SNP) | Generations Chronic Care Savings (HMO C-SNP) | Generations Dual Support (D-SNP) | Generations Dual Premier (D-SNP) | State of Oklahoma Group Retirees (HMO) | ||
| 100% | $0 | $0 | $0 | $0 | $0 | $0 | $176.10 | |
| 75% | $0 | $0 | $0 | $0 | $0 | $0 | $184.30 | |
| 50% | $0 | $0 | $0 | $0 | $0 | $0 | $192.50 | |
| 25% | $0 | $0 | $0 | $0 | $0 | $0 | $200.70 | |
* This does not include any Medicare Part B premium you may have to pay.
2022 Premium Subsidy Tables for Those Who Qualify for Extra Help
If you know you qualify for or are already receiving help to pay for your Medicare prescription drug plan, learn how much you will pay for your monthly premium as a member of a Medicare Advantage plan. The premiums listed in the table below include coverage for both medical services and prescription drug coverage.
| Your Extra Level of Help | Your Monthly Premium* | |||||||
|---|---|---|---|---|---|---|---|---|
| Generations Classic (HMO) | Generations Classic Choice (HMO-POS) | Generations Select (HMO) | Generations Classic Plus (HMO) - 022 | Generations Classic Plus (HMO) - 023 | Generations Special Care (HMO C-SNP) | Generations Special Care Savings (HMO C-SNP) | State of Oklahoma Group Retirees (HMO) | |
| 100% | $0 |
$0 |
$0 | $0 | $0 | $0 | $0 | $174.10 |
| 75% | $0 | $2.50 | $7.20 | $0 | $0 | $0 | $0 | $181.80 |
| 50% | $0 | $5.00 | $14.50 | $0 | $0 | $0 | $0 | $189.50 |
| 25% | $0 | $7.50 | $21.70 | $0 | $0 | $0 | $0 | $197.30 |
* This does not include any Medicare Part B premium you may have to pay.