10/30/2025

Medicare Prescription Payment Plan (M3P) Phone number to M3P Dedicated Team: 866-845-1803 ▪ Goes live 9/15 ▪ Open 24 hours, 7 days a week ▪ Internal Transfer Number (DO NOT give to customer): 866-883-3177 ▪ TTY Users: 800-716-323

Extra Help Benefits - Low Income Subsidy (LIS)

Who qualified for Cost Sharing - Extra Help LIS? (refer to RDS QRT 5.1 > Extra Help Benefits / LIS)

1. Certain groups determined to be qualified for other federal programs automatically qualify for LIS

• those who get full Medicaid Benefits

•               get Supplemental Security Income (SSI)
  

•               have Medicaid helping in their Medicare Premiums
  

1. Beneficiaries auto=qualified for Extra Help are auto-enrolled unless

• Already in Part D plan
• Choose and join a plan on their own
• enrolled in employer/union plan receiving subsidy
• call the plan or 1-800-MEDICARE to opt out

How can a beneficiary submit a form for Extra Help

• can submit anytime Beneficiaries or someone on their behalf can submit Extra Help Application
• calling customer service (proactively offer to help by Member Service Advocates)
• written
• online
• local organizations If denied, beneficiaries can re-apply

How does extra help work?

1. EXTRA HELP LIS has different subsidy levels based on a review of beneficiaries' income, assets, and overall "net worth"
2. Subsidy Levels will have corresponding percentage of the monthly premium
3. All extra help qualifiers...
4. Plans are notified if Individuals qualify for Extra Help
5. Coverage for Extra Help is effective 2 months after this CMS notification
6. Plans refund the following costs back to effective date of Extra Help

• Deductibles/Premiums
• Cost-sharing assistance

Zero deductible-meaning they may not be required to pay the standard calendar year deductible out-of-pocket, this amounts are paid on behalf of beneficiaries by the government.

2025 LIS Chart (refer to RDS QRT 5.1 > Extra Help Benefits / LIS)

What term refers to a percentage of the cost of an insured service paid by insured individual

• coinsurance what term refers to a fixed fee
• copay Catastrophic Phase, customers are responsible for
• $0 In deductible customers are responsible for 100% of the drug cost out of pocket
• 100% What term refers to the amount paid for insurance coverage
• Premium