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Is Your Client Qualified for LIS Medicare Extra Help?

LIS (Low Income Subsidy) is a federal program, commonly referred to as Medicare Extra Help, that helps Medicare beneficiaries pay for their prescription drugs. The program is designed to help beneficiaries who do not qualify for Medicaid but still need financial assistance. Beneficiaries with LIS save an average of almost $4,000 per year on their prescription drugs. That means that people can pay about $3.40 for a prescription instead of $40 or more.

Most Medicare eligibles don’t even know if they are eligible for LIS. You can help your existing clients better afford their health care by helping them apply for LIS. You can also encourage new leads to apply, giving them an opportunity to refer back to you again when they want to purchase new plans.

Benefits of the LIS Program

The LIS Medicare Extra Help program provides tremendous support for prescription drug coverage for clients with Part D and Medicare Advantage plans.

LIS Covers:

  • Part D premiums
  • Annual deductibles
  • Coinsurance and copayments
  • Donut Hole gap
  • Part D late enrollment fees

2019 Qualifications for LIS

To qualify for the LIS Medicare Extra Help Program, the client’s income must be no more than 150 percent of the Federal Poverty Level, which is $18,735 annually for an individual, and 25,365 for a married couple. That breaks down to a monthly income of $1040.83 for an individual, or $1561.25 for a married couple.* That includes income from all sources such as:

  • Wages
  • Social Security Income
  • Annuities
  • Family Support

The client’s total assets must be less than or equal to $14,100 for an individual or $28,150 for a married couple.* Assets include:

  • Real Estate
  • Stocks and bonds
  • Mutual Funds
  • Individual Retirement Accounts (IRAs)

*These numbers are all from 2019 and are subject to change each year.

How to Find LIS Medicare Leads

The best way to find seniors and Medicare eligibles that need help applying for LIS is by going to them. Talk to event coordinators and owners at senior living and recreational centers as well as banks, malls, community events like fairs and farmers markets, etc. to see if you can host a table or booth. You won’t make any direct sales by helping Medicare eligibles and seniors apply for LIS, but you’ll build relationships and develop some strong leads.

IMPORTANT – You must register your event as an “informal sales event” with CMS. Even though you won’t be selling at the event, you won’t be able to collect lead information and permission to call without classifying the event as such.

LIS Medicare Extra Help | Senior Market Advisors
LIS Medicare Extra Help | Senior Market Advisors

When you pitch to event coordinators, remember to discuss what they can gain from hosting your event. Tailor your pitch to the type of organization. For instance, if you want to host LIS applications at a senior living center, talk to the owner about how the seniors will be able to apply their prescription drug savings toward their monthly living fees.

The only thing the event coordinator will have to do is hold a sign up sheet if you have one. Sign up sheets with time slots for appointments are a good idea to prevent seniors and Medicare eligibles from all coming at one time and having to wait in a line. But, be careful: CMS compliance states that you cannot hold a sign up sheet. However, the event coordinator can do that for you.

When seniors and Medicare eligibles come to your events and fill out applications, ask them to fill out lead cards as well (as long as you have CMS’ permission), giving you permission to call them later to discuss their health plan. Additionally, make sure to follow up with your attendees after about one month. Ask if they received their LIS application response – if they were approved, then help them proceed by setting up an appointment with them. Don’t forget to also ask them to agree to a Scope Of Appointment so that you can discuss their Medicare plan in that appointment.  If they were not approved for LIS, let them know that you can help them make changes to their plan during AEP.

Direct Mail for Generating Leads

One way to reach your target audience is by sending direct mail. Send marketing materials to assisted living facilities or to your potential clients’ neighborhoods. It may be smart to advertise to low-income housing, but be aware that many insurance carriers will require you to notify them before you market to Section 8 or HUD communities. If you need help creating a direct mail campaign, Senior Market Advisors has an experienced marketing team that can guide you through the process and set you up for success. We even have an in-house print shop that will save you a ton of money because you won’t have to outsource your direct mailing services.

Medicare and Medicaid Eligibles

If your clients qualify for the LIS Medicare Extra Help Program, they’ll likely also qualify for Medicaid. Low-income clients who qualify for both Medicare and Medicaid are called “dual eligible,” and they can enroll in Medicare Advantage plans called Dual Special Needs Plans (DSNP). Most DSNPs include enticing benefits such as $0 monthly premiums and dental coverage.

When you sell DSNPs you also have the advantage of being able to sell them year-round without having to wait for AEP. After you’ve enrolled clients in a DSNP, be sure to follow up and find out if they’re satisfied with their current coverage. If they need to make changes, set up an appointment to discuss your client’s needs. You’ll get the commission if they make changes during your meeting.

Save Your Clients Money

With LIS, you’re helping clients save money in a way that they had probably not even heard of before. You won’t make an immediate profit, but you’ll be building solid relationships with new clients. If you can save your clients money before you’re even earning commissions from their plans, they’ll trust you later. They’ll look to you for answers to questions, to handle their concerns, and to make changes to their Medicare Plans.

What are you waiting for? Contact your local Medicare eligible and senior facilities and event coordinators now, so you can simultaneously help beneficiaries and grow your business.

Contract With Us

At Senior Market Advisors, we give our agents the tools they need to succeed. We offer a custom CRM system, top-tier commissions, and a dedicated sales and marketing team. Ready to start contracting? Visit our eContracting system today.

This post was originally published on February 08, 2017, by Anastasia Iliou and was updated on May 08, 2019, by Troy Frink.