Medicare beneficiaries with low income and resources may be able to get extra help to pay for prescription drug costs. This is called a low income subsidy (LIS). Those eligible for this low income subsidy will get help paying for their monthly premium, yearly deductible, prescription coinsurance and co-payments and no gap in coverage.

If you receive a low income subsidy, you will generally pay lower plan premiums, but you must still pay your Medicare Part B premiums.

To be a member of OneCare (HMO SNP), you must have full Medi-Cal benefits. If you have full Medi-Cal benefits, OneCare does not charge you a premium. Also, if you have full Medi-Cal benefits, the State of California pays your Medicare Part B premiums.

The table below shows what your premium would be if you joined OneCare.

*Note: Persons with levels of extra help of 75%, 50%, and 25% are not eligible for OneCare. OneCare members must have Medicare Part A and Part B and have full Medi-Cal benefits.

The Centers for Medicare & Medicaid Services (CMS) systems do not always show a beneficiary's correct low income subsidy (LIS) status. As a result, your Part D plan might not have the most up-to-date and correct subsidy information for you. So, as of 2006, CMS added a policy called best available evidence (BAE). This policy makes plans set up the correct cost-sharing for low-income beneficiaries when they find out that the beneficiary's information is not correct.

For more information regarding BAE policy, click here.

People with limited incomes may qualify for extra help to pay for their prescription drug costs. If you qualify, Medicare could pay for 75% or more of your drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify won’t have a coverage gap or a late enrollment penalty. Many people qualify for these savings and don’t even know it. For more information about this extra help, contact your local Social Security office, or call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. You can also apply for extra help online at www.socialsecurity.gov/prescriptionhelp.