2017 Medicare Stand-Alone Part D Plans
in Illinois That Offer a $0 Premium with
Full Low-Income Subsidy (LIS)
Company Name
Plan Name
Monthly Drug
Premium
(Medicare will pay this
premium for
individuals with full
LIS)
Annual Drug
Deductible
(Medicare will pay the
deductible for
individuals with full
LIS)
Aetna Medicare
Aetna Medicare Rx Saver
(S5810-051)
$29.80
$400
Cigna-HealthSpring Rx
***under sanction
Cigna-HealthSpring Rx Secure
(S5617-224)
$20.60
$400
EnvisionRx Plus
EnvisionRxPlus
(S7694-017)
$29.00
$400
HISC – Blue Cross Blue
Shield of Illinois
Blue Cross MedicareRx Basic
(S5715-012)
$26.10
$400
Humana Insurance
Company
Humana Preferred Rx Plan
(S5884-107)
$25.90
$400
SilverScript
SilverScript Choice
(S5601-034)
$28.40
$0
UnitedHealthcare
Symphonix Value Rx
(S0522-001)
$27.40
$400
UnitedHealthcare
AARP MedicareRx Saver Plus
(S5921-362)
$29.80
$400
WellCare Classic
WellCare
(S4802-087)
$26.50
$400
***Note: Plans under sanction allow for current members to remain in this plan but prohibits
new members from enrolling in the plan.
What is the Low-Income Subsidy?
The Low-Income Subsidy, also referred to as LIS or “Extra Help” is a federal prescription drug
assistance program to help people with Medicare pay for their Medicare Part D costs including
monthly Part D plan premiums, annual deductible and drug co-payments. The Social Security
Administration (SSA) processes LIS applications and determines eligibility and the Centers for
Medicare and Medicaid Services (CMS) administers the program.
How do I apply for LIS?
You may apply for LIS by submitting an application online through Social Security’s website at
www.socialsecurity.gov or by mailing in a paper application. Please contact Social Security at
(800)772-1213 to request an application.
Revised October 2016
2016 Low-Income Subsidy
Income and Asset Limits
(Updated limits will be released in early 2017)
Full Low-Income Subsidy
Individual
Income
$1,336 monthly
Couple
$1,802 monthly
Asset
$13,930*
$8,780*
Partial Low-Income Subsidy
Individual
Couple
Income
$1,485 monthly
$2,002 monthly
Asset
$13,640*
$27,250*
* Resource limits include $1,500 per person burial expenses
Revised October 2016