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) click here.

Click Here to 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”.