If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your monthly plan premium as a member of our health plan. Extra help is referred to as low income subsidy (LIS).
People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for seventy-five (75%) percent of drug costs including monthly prescription drug premiums, annual deductibles, copayments and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty (LEP). Many people are eligible for these savings and don’t even know it.
The table below shows you what your monthly plan premium will be if you get extra help. The premiums listed below do not include any Part B premium that you may have to pay.
|Your Level of Extra Help
||Monthly Premium Optima Medicare Value HMO*
||Monthly Premium Optima Medicare Prime HMO*
*This does not include any Medicare Part B premium you may have to pay.
Optima Medicare premiums include coverage for both medical services and prescription drug coverage.
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help call:
- 1-800-MEDICARE (1-800-633-4227) or TTY/TDD users call 1-877-486-2048 (twenty-four (24) hours a day/seven (7) days a week),
- Your State Medicaid Office, or
- The Social Security Administration at 1-800-772-1213. TTY/TDD users should call 1-800-325-0778 between 7 a.m. and 7 p.m., Monday through Friday.
If you have any questions, please call Member Services at 1-800-927-6048. TTY users can contact us through the Virginia Relay Service at 1-800-828-1140 or 711. From October 1 - February 14, you can call us 7 days a week from 8 am to 8 pm EST. From February 15 - September 30, you can call us Monday through Friday from 8 am to 8 pm EST.