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  • With Extra Help/LIS as long as the plan covers the medications, they will be covered at the rate listed on the LIS Table or the rate charged by the plan, whichever is less.

  • Beneficiaries will pay the same amount under LIS for a 90 day supply as a 30 day supply.

  • Beneficiaries will not be responsible for the following costs:

    • The gap phase

    • The Part D IRMMA

    • The Part D late enrollment penalty

Enrollment Reasons

Plan

Medicare Code/Reason

Dialer

Code/Reason

Uses

MA/MAPD/PDP

MDE

MDE

May be used once per quarter.

Additional Resources

Right-Click Here and open in a new tab to view the ­2021 LIS Table.

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