Versions Compared

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.

Verification

A great place in the call to verify LIS is on the “Medicare Determine Eligibility” “Verify Coverage” plate.

...

  • Right-click and open this link in a new tab to open the step-by-step Marx guide.

  • Follow the instructions in the guide to determine:

    • Customer’s name as it appears on their Medicare card

    • Date of Birth

    • Address

    • Part A/B eff dates

    • Current plan along with plan’s effective date

    • LIS (Low Income Subsidy) level
      Note: If customer does not have LIS, they do not have Medicaid

Sales Tips

  • 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 coverage gap phase

    • The Part D IRMMA

    • The Part D late enrollment penalty

Enrollment Reasons

Plan

Medicare Code/Reason

Dialer

Code/Reason

Uses

MAPD/PDP

MDE

MDE

May be used once per quarter (during the first 3 quarters of the year) if there are no recent changes to Medicaid or LIS level.

MAPD/PDP

MCD

MCD

Changes to Medicaid or LIS level this month, or in the past 2 months.

Additional Resources

Right-Click Here and open in a new tab to view the ­2022 LIS Table.