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Extra Help/Low Income Subsidy

Extra Help/Low Income Subsidy

Medicare Extra Help

Extra Help, also known as the Part D Low-Income Subsidy (LIS), is a federal program that helps pay the out-of-pocket costs of Medicare prescription drug coverage for people who have limited income and resources. Resources include your savings and stocks in your 401K or other retirement plan, but not your home or care.

If you qualify for Extra Help, you will get help paying for any Medicare drug plan’s monthly premium, yearly deductible, and drug copays.

Questions?

°ä²¹±ô±ôÌý1.833.276.8306
(TTY users should call 711)

October 1 to March 31, 8:00 am to 8:00 pm, 7 days a week andÌýApril 1 through September 30, Monday through Friday, 8:00 am to 8:00 pm.

On certain holidays your call will be handled by our automated phone system.

Do I qualify for Extra Help?

You qualify for Extra Help if:

  • You get full Medicaid benefits. You will be automatically enrolled in the Extra Help program. Medicare will mail you a letter with more information.
  • You get help from Medicaid paying your Medicare premiums, or if you receive Supplemental Security Income (SSI). You will be automatically enrolled in the Extra Help program, but you will need to enroll in a Medicare prescription drug plan.
  • You have limited income and resources and don’t get help from Medicaid. You can apply for Extra Help by calling Medicare toll-free at 1.800.MEDICARE (TTY 1.877.486.048), 24 hours a day/7 days a week.

Best Available Evidence (BAE)

The Best Available Evidence (BAE) policy makes sure that people getting Extra Help are not charged too much or have higher copays than they are supposed to.

The Centers for Medicare & Medicaid Services (CMS) requires that Medicare plans, like ÀÖ²¥´«Ã½app (HMO D-SNP) accept Extra Help if you are eligible to receive it, even if your Medicare records don’t yet show it. Once you send Best Available Evidence to ÀÖ²¥´«Ã½app, we will ask CMS to update your status in their system.

Some acceptable forms of Best Available Evidence are:

  • A copy of your Texas Medicaid card
  • A copy of a state document that shows you have Texas Medicaid
  • A print-out from a state electronic enrollment file or from your the Texas Medicaid system that shows you have Medicaid
  • A screen shot from the Texas Medicaid system showing your Medicaid status
  • Any other document from the state that shows you have Texas Medicaid
  • A Social Security Administration (SSA) Award Letter
  • An “Application Filed by Deemed Eligibleâ€� (SSA publication HI 03094.605) confirming that you are “automatically eligible for Extra Helpâ€�

Please visit to learn more about BAE policy. (Note: This opens to an external website)

2027 LIS Chart

The 2027 LIS Chart shows you what your monthly plan premium will be if you get Extra Help.

Your level of extra help Monthly Premium for ÀÖ²¥´«Ã½app DualCare Access (HMO D-SNP) and ÀÖ²¥´«Ã½app DualCare Aligned (HMO D-SNP)
100%
$0.00
75%
$0.00
50%
$0.00
25%
$0.00

2026 LIS Chart

The 2026 LIS Chart shows you what your monthly plan premium will be if you get Extra Help.

Your level of extra help Monthly Premium for ÀÖ²¥´«Ã½app DualCare Access (HMO D-SNP) and ÀÖ²¥´«Ã½app DualCare Aligned (HMO D-SNP)
100%
$0.00
75%
$0.00
50%
$0.00
25%
$0.00

Need More Information?

Call Medicare:

  • 1.800.MEDICARE (1.800.633.4227)
    TTY 1.877.486.2048
    24 hours a day, 7 days a week
  • Visit (Note: this opens to an external website)

Call the Social Security Office:

  • 1.800.772.1213
    TTY 1.800.325.0778
    7:00 am – 7:00 pm, Monday – Friday
  • Visit (Note: this opens to an external website)

Call the Texas THMP State Pharmacy Assistance Program (SPAP):

  • 1.800.255.1090
    TTY 711
    8:00 am – 5:00 pm, Monday – Friday
  • Visit (Note: this opens to an external website)

Call ÀÖ²¥´«Ã½app Member Services:

  • 1.833.276.8306
    TTY 711

    October 1 to March 31, 8:00 am to 8:00 pm, 7 days a week andÌýApril 1 through September 30, Monday through Friday, 8:00 am to 8:00 pm.

    On certain holidays your call will be handled by our automated phone system.

Refer to your Evidence of Coverage for additional details on Extra Help/Low Income Assistance (LIS) and view the LIS premium chart located on the plan’s detail page. The chart will show you what your monthly plan premiums would be if you get Extra Help.

H9826_IT_10045_092919_M Last updated September 30, 2026.

Why Choose ÀÖ²¥´«Ã½app?

As a local nonprofit health plan, ÀÖ²¥´«Ã½app gives you plenty of reasons to join our ÀÖ²¥´«Ã½app. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, ÀÖ²¥´«Ã½app is always working life forward for you and your family.

“ÀÖ²¥´«Ã½app is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.â€�

– Cecily
Member of ÀÖ²¥´«Ã½app

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