Low Income Subsidy Premiums for this Plan Year
Medicare provides Part D premium and cost-sharing assistance to beneficiaries who qualify for the program’s low income subsidy, also called the LIS. An enrollee’s premium will generally be lower once he or she receives extra help from Medicare, if the enrollee joins an Essence plan with a monthly premium. If you qualify for extra help, the amount of extra help you receive will determine your total monthly plan premium as a member of our Plan. The premiums listed are for both medical services and prescription drug benefits (Medicare Advantage-Part D plans only).
Missouri and Illinois Market Plans
Essence Advantage®(HMO)
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0.00
75%
$0.00
50%
$0.00
25%
$0.00
Essence Advantage Plus®(HMO)
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$26.30
75%
$34.70
50%
$43.10
25%
$51.60
Essence Advantage Select (HMO)
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0.00
75%
$0.00
50%
$0.00
25%
$0.00
Essence Dual Advantage (HMO-DSNP)
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0.00
75%
$9.10
50%
$18.20
25%
$27.50
Essence Advantage Choice Plus (PPO)
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$6.70
50%
$13.50
25%
$20.20
Essence Advantage (HMO) – Boone County
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
Essence Advantage Choice (PPO)
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
Essence Advantage (HMO) – Southwest Missouri
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
California Market Plans
Essence Advantage Platinum (HMO) – Santa Clara
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$40.10
75%
$49.90
50%
$59.60
25%
$69.30
Essence Advantage Platinum (HMO) – Alameda / San Mateo
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$48.10
75%
$57.90
50%
$67.60
25%
$77.30
Essence Advantage Gold (HMO) – Santa Clara
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$25.80
75%
$26.80
50%
$27.90
25%
$28.90
Essence Advantage Gold (HMO) – Alameda / San Mateo
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$18.10
75%
$27.90
50%
$37.60
25%
$47.30
Essence Advantage Select (HMO) – Santa Clara
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
Arkansas Market Plans
Essence Advantage (HMO)
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
Essence Advantage Plus (HMO)
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
Cincinnati Area Market Plans
Essence Advantage (HMO) – Kentucky
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
Essence Advantage Plus (HMO) – Kentucky
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
Essence Advantage (HMO) – Ohio
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
Essence Advantage Plus (HMO) – Ohio
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
Essence Advantage Choice (PPO) – Ohio
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
Northeast Georgia Market Plans
Essence Advantage (HMO-POS)
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
Essence Advantage Choice (PPO)
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
Louisville / Lexington Market Plans
Essence Advantage (HMO)
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
Essence Advantage Plus (HMO)
Level of Extra Help
100%
100%
75%
75%
50%
50%
25%
25%
Your Monthly Premium
100%
$0
75%
$0
50%
$0
25%
$0
To learn more about what information is needed to have your records immediately updated to reflect that you qualify for “extra help” (low income subsidy).
Learn more about getting extra help to pay for your prescription drug premiums and costs.
Part D sponsors must provide access to Part D drugs at the correct LIS cost-sharing level when presented with evidence of LIS eligibility. Learn more about CMS’ “Best Available Evidence (BAE) policy”.
