2014 Medicare Advantage Plans That

2014 Medicare Advantage Plans That

Offer a $0 Drug Premium with

Full Low-Income Subsidy (LIS)

County / Company Name / Plan Name / Plan’s Monthly Health Premium Beneficiary is still responsible for the plan’s monthly health & Part B premiums / Monthly Drug Premium / Annual Drug Deductible
Cook / Humana Health Plan, Inc. / Humana Gold Plus H1406-013 (HMO) / $0.00 / $0.00 / $0.00
Cook / Cigna-HealthSpring / Cigna-HealthSpring Premier H1415-021 (HMO-POS) / $0.00 / $0.00 / $0.00
Cook / Cigna-HealthSpring / Cigna-HealthSpring Primary H1415-024 (HMO) / $0.00 / $23.50 / $310.00
Cook / WellCare / WellCare Value H1416-009 (HMO-POS) / $0.00 / $0.00 / $0.00
Cook / WellCare / WellCare Rx H1416-019 (HMO) / $0.00 / $0.00 / $0.00
Cook / Aetna Medicare / Aetna Medicare Value Plan H1419-001 (HMO) / $0.00 / $0.00 / $0.00
Cook / Community Care Alliance of Illinois, NFP / Community Care Alliance of Illinois H3071-002 (HMO) / $0.00 / $0.00 / $310.00
Cook / Blue Cross Blue Shield of IL, NM / Blue Cross Medicare Advantage Basic H3822-001 (HMO) / $0.00 / $0.00 / $0.00
Cook / Blue Cross Blue Shield of IL, NM / Blue Cross Medicare Advantage Basic Plus H3822-007 (HMO-POS) / $0.00 / $0.00 / $0.00
Cook / Blue Cross Blue Shield of IL, NM / Blue Cross Medicare Advantage Premier Plus H3822-008 (HMO-POS) / $23.10 / $14.90 / $0.00
Cook / UnitedHealthcare / AARP MedicareComplete Plus H3887-003 (HMO-POS) / $0.00 / $0.00 / $0.00
Cook / Humana Insurance Company / HumanaChoice R5826-009 P (Regional PPO) / $82.90 / $29.10 / $310.00
DuPage / Humana Health Plan, Inc. / Humana Gold Plus H1406-028 (HMO) / $0.00 / $0.00 / $0.00
DuPage / Cigna-HealthSpring / Cigna-HealthSpring
H1415-021 Premier (HMO-POS) / $0.00 / $0.00 / $0.00
DuPage / Cigna-HealthSpring / Cigna-HealthSpring Primary H1415-024 (HMO) / $0.00 / $23.50 / $310.00
County / Company Name / Plan Name / Plan’s Monthly Health Premium Beneficiary is still responsible for the plan’s monthly health & Part B premiums / Monthly Drug Premium / Annual Drug Deductible
DuPage / Community Care Alliance of Illinois, NFP / Community Care Alliance of Illinois H3071-002 (HMO) / $0.00 / $0.00 / $310.00
DuPage / Blue Cross Blue Shield of IL, NM / Blue Cross Medicare Advantage Basic H3822-001 (HMO) / $0.00 / $0.00 / $0.00
DuPage / Blue Cross Blue Shield of IL, NM / Blue Cross Medicare Advantage Basic Plus H3822-007(HMO-POS) / $0.00 / $0.00 / $0.00
DuPage / Blue Cross Blue Shield of IL, NM / Blue Cross Medicare Advantage Premier Plus H3822-008 (HMO-POS) / $23.10 / $14.90 / $0.00
DuPage / Humana Insurance Company / HumanaChoice R5826-009 P (Regional PPO) / $82.90 / $29.10 / $310
Grundy / Humana Insurance Company / HumanaChoice R5826-009 P (Regional PPO) / $82.90 / $29.10 / $310.00
Kane / Humana Health Plan, Inc. / HumanaChoice H1406-022 (HMO) / $40.00 / $0.00 / $0.00
Kane / Cigna-HealthSpring / Cigna-HealthSPring Premier H1415-021(HMO-POS) / $0.00 / $0.00 / $0.00
Kane / Cigna-HealthSpring / Cigna-HealthSpring Primary 1415-024(HMO) / $0.00 / $23.50 / $310.00
Kane / WellCare / Wellcare Value H1416-009 (HMO-PPO) / $0.00 / $0.00 / $0.00
Kane / WellCare / WellCare Rx H1416-019 (HMO) / $0.00 / $0.00 / $0.00
Kane / Community Care Alliance of Illinois, NFP / Community Care Alliance of Illinois H3071-002 (HMO) / $0.00 / $0.00 / $310.00
Kane / Blue Cross Blue Shield of IL, NM / Blue Cross Medicare Advantage Basic H3022-001 (HMO) / $0.00 / $0.00 / $0.00
Kane / Blue Cross Blue Shield of IL, NM / Blue Cross Medicare Advantage Basic Plus H3822-007(HMO-POS) / $0.00 / $0.00 / $0.00
Kane / Blue Cross Blue Shield of IL, NM / Blue Cross Medicare Advantage Premier Plus H3822-008(HMO-POS) / $23.10 / $14.90 / $0.00
Kane / UnitedHealthcare / AARP MedicareComplete Plus H3887-003 (HMO-POS) / $0.00 / $0.00 / $0.00
Kane / Humana Insurance Company / HumanaChoice R5826-009 (PPO) / $82.90 / $29.10 / $310.00

AgeOptions on behalf of the Make Medicare Work Coalition October 2013

County / Company Name / Plan Name / Plan’s Monthly Health Premium Beneficiary is still responsible for the plan’s monthly health & Part B premiums / Monthly Drug Premium / Annual Drug Deductible
Kankakee / WellCare / WellCare Value H1416-009 (HMO-POS) / $0.00 / $0.00 / $0.00
Kankakee / WellCare / WellCare Rx H1416-019 (HMO) / $0.00 / $0.00 / $0.00
Kankakee / Humana Insurance Company / HumanaChoice R5826-009 P (Regional PPO) / $82.90 / $29.10 / $310.00
Kendall / Humana Health Plan, Inc. / Humana Gold Plus H1406-022 (HMO) / $40.00 / $0.00 / $0.00
Kendall / Coventry Health Care of Illinois, Inc. / Advantra H7301-002(PPO) / $9.30 / $19.70 / $0.00
Kendall / Humana Insurance Company / HumanaChoice R5826-009 P (Regional PPO) / $82.90 / $29.10 / $310.00
Lake / Humana Insurance Company / HumanaChoice R5826-009 P (Regional PPO) / $82.90 / $29.10 / $310.00
McHenry / Humana Health Plan, Inc. / Humana Gold Plus H1406-022 (HMO) / $40.00 / $0.00 / $0.00
McHenry / Community Care Alliance of Illinois, NFP / Community Care Alliance of Illinois H3071-002 (HMO) / $0.00 / $0.00 / $310.00
McHenry / Meridian Health Plan / Meridian Prime H5779-002 (HMO) / $0.00 / $0.00 / $310.00
McHenry / Humana Insurance Company / HumanaChoice R5826-009 P (Regional PPO) / $82.90 / $29.10 / $310.00
Will / Humana Health Plan, Inc. / Humana Gold Plus H1406-013 (HMO) / $0.00 / $0.00 / $0.00
Will / Cigna-HealthSpring / Cigna-HealthSpring Premier H1415-021 (HMO-POS) / $0.00 / $0.00 / $0.00
Will / Cigna-HealthSpring / Cigna-HealthSpring Primary H1415-024 (HMO) / $0.00 / $23.50 / $310.00
Will / WellCare / WellCare Value H1416-009 (HMO-POS) / $0.00 / $0.00 / $0.00
Will / WellCare / WellCare Rx H1416-019 (HMO) / $0.00 / $0.00 / $0.00
Will / Community Care Alliance of Illinois, NFP / Community Care Alliance of Illinois H3071-002 (HMO) / $0.00 / $0.00 / $310.00
Will / Blue Cross Blue Shield of IL, NM / Blue Cross Medicare Advantage Basic H3822-001 (HMO) / $0.00 / $0.00 / $0.00
County / Company Name / Plan Name / Plan’s Monthly Health Premium Beneficiary is still responsible for the plan’s monthly health & Part B premiums / Monthly Drug Premium / Annual Drug Deductible
Will / Blue Cross Blue Shield of IL, NM / Blue Cross Medicare Advantage Basic Plus H3822-007 (HMO-POS) / $0.00 / $0.00 / $0.00
Will / Blue Cross Blue Shield of IL, NM / Blue Cross Medicare Advantage Premier Plus H3822-008 (HMO-POS) / $23.10 / $14.90 / $0.00
Will / UnitedHealthcare / AARP MedicareComplete Plus H3887-003 (HMO-POS) / $0.00 / $0.00 / $0.00
Will / Humana Insurance Company / HumanaChoice R5826-009 P (Regional PPO) / $82.90 / $29.10 / $310.00

What is the Low-Income Subsidy?

The Low-Income Subsidy, also referred to as LIS or “Extra Help” is a federal prescription drug assistance program to help people with Medicare pay for their prescription drug costs. The Social Security Administration (SSA) processes LIS applications and determines eligibility and the Centers for Medicare and Medicaid Services (CMS) administers the program.

How does the Low-Income Subsidy (LIS) work with Medicare Advantage plans?

The LIS program provides the following benefits:

· Assistance with all or a portion of the monthly drug premium and deductible

· Low cost prescription drug co-payments at the pharmacy

· Part D donut hole (coverage gap) is eliminated

Beneficiary is responsible for:

· Plan’s Monthly Health Premium (covers medical and hospital benefits, and may cover extra benefits not usually covered by Original Medicare such as vision or dental)

· Part B Premium (unless enrolled in a Medicare Savings Program)

· Medicare Advantage co-pays or co-insurance amounts for each time a health service is used (e.g., primary care doctor co-pay or inpatient hospital stay co-pay)

· Prescription co-payments

Full LIS: between $1.20 and $6.35 for each 30-day supply filled

Partial LIS: $2.55, $6.35 or up to 15% coinsurance for each 30-day supply filled

Note: People who have both Medicare and Medicaid (called dual eligibles) and reside in a long-term care facility pay $0 co-pay for their prescription drugs. In addition, individuals who receive certain home and community based services will also pay $0 co-pays for their drugs.

How do I apply for LIS?

You may apply for LIS by submitting an application online through Social Security’s website at www.socailsecurity.gov or by mailing in a paper application. Please contact Social Security at (800)772-1213 to request an application.

2013 Low-Income Subsidy (LIS)

Income and Asset Limits

(2014 information will be released in early 2014)

Full Low-Income Subsidy

Individual / Couple
Income / $15,516 annually
($1,293 monthly) / $20,628 annually
($1,719 monthly)
Asset / $8,580* / $13,620*

Partial Low-Income Subsidy

Individual / Couple
Income / $17,235 annually
($1,436 monthly) / $23,265 annually
($1,939 monthly)
Asset / $13,300* / $26,580*

* Resource limits include $1,500 per person burial expenses

AgeOptions on behalf of the Make Medicare Work Coalition October 2013