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Medicare Part D Low-Income Subsidy & Medicaid Unwinding—Tips for Advocates

Starting in April 2023 and continuing through May 2024, older adults who are dually eligible for Medicare and Medicaid face redeterminations of their Medicaid eligibility, a process that was suspended during the COVID-19 Public Health Emergency (PHE). During this “Medicaid unwinding” period, advocates working with people dually enrolled in Medicare and Medicaid should know about two important features of the Medicare Part D Low Income Subsidy (“LIS” or “Extra Help”): (1) Medicaid termination does not immediately end LIS enrollment; and (2) LIS eligibility is more generous than Medicaid and Medicare Savings Program (MSP) eligibility rules in most states. This means that Medicare enrollees who lose their Medicaid eligibility will continue to get help with their prescription drug costs through the end of the year or longer.

A new fact sheet, Medicare Part D Low-Income Subsidy, Medicaid, and the End of the Public Health Emergency: Tips for Advocates, includes practice tips to help advocates ensure that older adults understand their LIS enrollment during Medicaid unwinding and their options for continuing their LIS coverage.

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