LIS – Low Income Subsidy – Extra Help
Get help paying for your prescriptions
Here’s #MoreAassistance
Even if you have high assets & Income
Beyond Part D Rx
Assistance Programs from the Manufacturer
and Government Programs
This tool includes Merck
CA Health Care Advocates – Resources for Rx Drug Savings
The Patient Access Network (PAN) Foundation is dedicated to helping federally and commercially insured people living with life-threatening, chronic and rare diseases with the out-of-pocket costs for their prescribed medications. Partnering with generous donors, healthcare providers and pharmacies, PAN provides the underinsured population access to the healthcare treatments they need to best manage their conditions and focus on improving their quality of life.
Pharmaceutical Assistance Program
National Patient Advocate Foundation
National Organization for Rare Disorders
California Prescription Drug Discount Program
At Medi-Cal participating pharmacies, you can get prescription drugs at the Medi-Cal rate plus a $0.15 processing fee. This rate may be lower than the Part D rate. Payments may not apply toward your Part D cost-sharing. This program should not be used as a substitute for Medicare Part D. To receive benefits, show your Medicare card at Medi-Cal participating pharmacies SB 393 2000
6 Hints to get help with Rx costs on Medicare.gov
Glaxo Smith Kline Rx Assistance
pfizer rx pathways.com Find Assistance That’s Right for You Pfizer RxPathways connects eligible patients to a range of assistance programs that offer insurance support, co-pay help,* and medicines for free or at a savings.† Enter the name of the medicine you’ve been prescribed. You can search one medicine at a time. Then answer a few questions to see which available program(s) may be right for you.
Financial Assistance Programs
- The Assistance Fund 877-245-4412
- GoodDays 877-968-7233
- HealthWell Foundation 800-675-8416 *Medicare only
- copaxone.com/shared-solutions
- RxAssist.org RxAssist can help you learn about ways to use pharmaceutical company programs and other resources to help reduce your medication costs. Look at our database and frequently asked questions to get started.
Manufactures Coupons
- If one has Part D Rx, the manufacturers cannot help out with coupons. One might consider dropping Part D or if you have Medicare Advantage Plan, finding one that doesn’t include Part D.
- We CANNOT advise you to do this. It’s beyond our pay grade and we are mandated to tell you about the penalty if you don’t purchase Part D. I’m having trouble finding a reliable plain English citation for this. Scroll down for hints from one of our wholesalers on using coupons and not using your Part D Rx plan.
- The intention for coupons is to steer patients away from cheaper generic alternatives and toward the brands that they produce. That is to increase demand for their drugs. Experts estimate that brand drug manufacturers are spending between $3 billion and $6 billion annually on coupon programs. Anti-Kick Back and all. HHS Report Mfg safeguards might not prevent coupons for Part D Rx. Legally, the use of drug co-pay cards and coupons by individuals with government funded health care and prescription drug benefits, such as Medicare and Medicaid, is prohibited by the federal anti-kickback statute.
- (2) Whoever knowingly and willfully offers or pays any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind to any person to induce such person—
- (A) to refer an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part under a Federal health care program, or SSA.gov
- (2) Whoever knowingly and willfully offers or pays any remuneration (including any kickback, bribe, or rebate) directly or indirectly, overtly or covertly, in cash or in kind to any person to induce such person—
Resources, Links, Bibliography
- No Coupons allowed for Part D Rx
- Late enrollment penalty if you don’t sign up for Medicare Part D Rx
- Part D Information for Pharmaceutical Manufacturers
- Why Can’t Medicare Patients Use Drugmakers’ Discount Coupons? NPR
- Yes, You Can Use GoodRx If You Have Medicare
- M ANUFACTURER SAFEGUARDS MAY NOT PREVENT COPAYMENT COUPON USE FOR PART D DRUGS
Here’s some hints from our wholesaler…
Coupons are allowed to be used in Medicare, but it is tricky. When a client uses a coupon, or a GoodRX or even the pharmacies billing costs (which are sometimes cheaper than the plan copay) the drug doesn’t get run through Medicare, it becomes a cash pay situation and it doesn’t go against the Medicare deductibles, donut hole, etc. So that is the negative.
I have many clients that have purchased drugs directly from the pharmacy to get a lower cost, and some that have used Good RX or even just googled their drugs and bought them online at a cheaper cost.
There are certain things that are much cheaper online, Progesterone is a big one that my female clients find cheaper online..
So, if the pharmacy will work with the client to help them find the lowest cost, there are alternatives for our Medicare clients. Not all pharmacies will do this however, so it is good to do some research on more expensive drugs to find alternative solutions.
#Understanding Medicare Advantage Plans (PDF) #12026
- MAPD Plans look like a great deal, as the "premium" is paid by fee from the Federal Government, on average $2k/year.Kff * MAPD Plans must cover all A & B services Medicare.Gov * generally they also cover Part D Rx.
- That's why the premium is very low or ZERO!
- Set a Zoom Meeting
- We can now do SOC Scope of Appointment, before the Meeting via a 3 minute recorded meeting 2 days before. AHIP Training Module 4 Page 14 *
- #Intake Form Berwick Needs Assessment Form - We can better prepare for the meeting
- Medicare Advantage (Medicare Part C): An Overview Hi Cap
- HMO - Narrow Networks?
- HI Cap CA Health Care Advocates Fact Sheet
- Do I just sign up with a Medicare Advantage Company and automatically get * Parts A & B or do I have to get those from Medicare.Gov * VIDEO
- Get Quotes, Full Information and Enroll
- MANDATED wording!: Think Advisor * ‘‘We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE to get information on all of your options.’’
- We disagree with the above wording, as we can use the same tools on Medicare.gov as they do!
- FYI a 4.27.2022 HHS Office of the Inspector General report found that MAPD plans denied 13% of prior authorizations that would have been covered under original Medicare (Conversely, Medi Gap, just follows what Medicare pays.)
- 88% of MAPD enrollees are happy
-
MAPD plans often include Dental & Part D - Rx Prescriptions and often have NO premiums!
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How is that possible?
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The Federal Government pays them around $700/month to handle your medical care. You must continue to pay your Medicare Part B premium of about $170/month. It's best to apply when you turn 65 for the supplement plans or advantage plans, as that's the main "Open Enrollment" period, guaranteed issue for any plan.
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-
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Medicare Advantage Plans also have an annual open enrollment now known as AEP Annual Election Period October 7 to December 15th.
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Additional Coverage is important as Medical Bills are increasing Seniors Credit Card Debt or leading to possible bankruptcy?
- If You Have Problems with Your Medicare Advantage Plan
- forbes.com/how-insurers-can-navigate-the-costs-of-medicare-advantage-benefits
- politico.com/medicare-advantage-plans-congress
- Uncle Sam wants you to help stop insurers' bogus Medicare Advantage sales tactics
- ca health advocates/using-ai-to-deny-care
- Dodging the Medicare Enrollment Deadline Can Be Costly
- Medicare Advantage Increasingly Popular With Seniors — But Not Hospitals and Doctors
- Medicare Advantage is bad for patients and bad for investors
- When Medicare Advantage Plans Terminate Coverage
- Medi-Cal D-SNP Feasibility Study
#GoodRx
We do not know who they are. We are not endorsing them. We’ve heard from some of our clients, who are happy with them.
- GoodRx said Wednesday its dispute last year with Kroger continues to affect its bottom line.The company reported a first-quarter net loss of $3.3 million, or 1 cent per share, compared with net income of $12.3 million, or 3 cents per share, a year ago. Quarterly revenue totaled $184 million, down 10%. The company’s biggest revenue driver, its prescription transaction business, saw a 13% decline, to $155.5 million this year from $134.9 million in 2022.GoodRx blamed the decline in the prescription transaction business on its contract dispute last year with Kroger, the national grocery chain that temporarily stopped accepting Good Rx’s discounts at the point of sale in May 2022. The company also blamed the Kroger issue for a 5% decrease in monthly active customers from 6.4 million in 2022 to 6.1 million this year. Modern Health Care *
- Los Angeles Times 9.17.2020 Good Rx going IPO - They can make $$$ since the Rx pricing system is so crazy!
- Times Rx.com
- On the other hand...
#Co-Pay Accumulator Programs
When Copay Assistance Backfires on Patients
If a patient has an insurance plan with an accumulator program, all copays funded by the manufacturer copay savings program will not count towards their deductible and annual maximum out-of-pocket costs. When this patient goes to refill their prescription without the copay savings program, they will be responsible for the full cash price of the drug until they reach their deductible and out-of-pocket annual maximum.
In the absence of accumulator programs, when a patient uses a copay savings program, the portion paid by the manufacturer would contribute to the patient’s deductible. However, copay accumulator programs are designed to keep manufacturer contributions from counting towards a patient’s deductible and annual maximum out-of-pocket costs.
- CMS allows all Insurance Plans to do this. Good Rx.com * Actuary Magazine.org * Policy Med.com * ThomsonReuters *
- Los Angeles Times explanation April 2018
-
Court Ruling in favor of Rx companies: The dispute centers on programs in which drug companies help patients cover their share of the prescription drug costs that they otherwise could not afford.
In recent years, some insurers have established so-called accumulator adjustment programs, in which they do not count assistance toward patients’ deductibles and out-of-pocket maximums. Such programs effectively capture some of the assistance for insurers instead of patients. Read More Reuters.com
Response from Anthem Blue Cross CA…
Blue Shield of CA
This confirms member’s who use manufacturer coupons for prescriptions, will be credited the amounts paid towards their deductible/out-of-pocket.
Oscar
At this time, the only amount that will contribute towards the members deductible and/or out of pocket maximums will be the amount that the member pays.
Pamphlets, Brochures & Websites to help prevent Fraud
- Protect yourself from Medicare Fraud Publication # 10111
- Prevent Fraud Publication # 11491
- Medicare Learning Network Prevent, Detect & Report Fraud & Abuse
- California Department of Insurance on Fraud
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New MD’s – how to avoid Medicare & Medicaid – Medi Cal Fraud and Abuse
- Medicare Fraud & Abuse-12-17-15 Hi Cap CA Health Care Advocates
- Doctor who performed unneeded procedures guilty in $12-million Medicare fraud scheme Los Angeles Times
- CMS will be able to revoke healthcare providers or suppliers’ Medicare enrollment if they are affiliated with targeted “bad actors,” a final rule issued Wednesday established.
- As part of the CMS’ “Program Integrity Enhancements to the Provider Enrollment Process” going into effect Nov. 4, its new “affiliations” provision allows authorities to bar individuals and organizations that “pose an undue risk of fraud, waste or abuse based on their relationships with other sanctioned entities.” Modern Health Care *
- Medicare and Medicaid fraudsters continue to steal taxpayer money
YouTube VIDEO's
Low Income Subsidy – Extra Help
The Low-Income Subsidy (LIS) program/extra helps pay for a portion of Part D prescription drug plan costs, including Part D premiums, deductibles and copayments.
Depending on your income and assets, you may qualify for the full subsidy or a partial subsidy. All beneficiaries who qualify for the LIS program are permitted to change Part D plans once a month at anytime during the year. CA Health Care Advocates The full Low-Income Subsidy (LIS) program covers the premium and deductible of benchmark plans, that meet the minimum standards. This means you do not pay a premium or deductible if you receive the full LIS benefit and enroll in a benchmark plan. You are, however, still responsible for copayments of $3.70 to $9.20 for each covered prescription. CA Health Care Advocates
SSA.Gov LIS/Extra Help
What help can I receive?
The Social Security Extra Help is estimated to be worth about $5,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income (scroll down to view) and reside in one of the 50 States or the District of Columbia.
Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.
I feel that the brochure on Medicare Rx Coverage, their extra help section really explains it IMHO the best, simplest and easiest way to understand.
- See if you qualify for Extra Help and apply SSA.gov
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Qualifications to get Extra Help
- You have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance); and
- You live in one of the 50 States or the District of Columbia; and
- Your combined savings, investments, and real estate are not worth more than $29,160, if you are married and living with your spouse, or $14,610 if you are not currently married or not living with your spouse.
- (Do NOT count your home, vehicles, personal possessions, life insurance, burial plots, irrevocable burial contracts or back payments from Social Security or SSI.)
- Your annual income must be limited to $19,140 for an individual or $25,860 for a married couple living together. Even if your annual income is higher, you may still be able to get some help.
- Some examples where your income may be higher and you can still get Extra Help include if you or your spouse:
• Support other family members who live with you.
• Have earnings from work.
• Live in Alaska or Hawaii.
- Some examples where your income may be higher and you can still get Extra Help include if you or your spouse:
- EXCEPTION: If you have Medicare and Supplemental Security Income (SSI) or Medicare and Medicaid [Medi-Cal] you automatically will get the extra help. Publication 10525 * Social Security ONLINE Application for Extra Help * Publication 10508 Understand
Prescription Drug 2025 #RxGuide
PDF # 11109
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Coverage Gap - Donut Hole $2,000 Cap
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- Medicare Part D Rx generally runs say $30 to $100. See link below for how to shop premiums.
- Scope of appointment - permission to discuss Rx and MAPD Plans
- Our Webpage Premiums for those with High Income Parts D Rx & B Doctor Visits
- Medicare Rules for High Income People Medicare Costs # 11579
- Our #High Income Surcharge Video Explanation
- Ways to pay your premium - See brochure above.
- Kaiser Foundation Introduction - Overview
- Fact Sheet Medicare Part D CA Health Care Advocates Hi Cap
-
. Prescription Drugs Hi Cap
- Medicare Part D: An Overview – 10-31-23
- Prescription Drug Resources – 11-07-22
- When Your Part D Prescription is Denied– 11-22-22
- Medicare Rx Benefit Manual Rev 1.2016 83 pages
- Resources: Medicare Drug Coverage (Part D) Mini-Course & Podcast Series CMS
- Network Pharmacies, Formularies & Common Coverage Rules # 11136
- Insulin Maximum Co Pay $35
- Graphic on Part D Premium Increases & Why?
- Maximus Appeals LEP Late Enrollment Penalty
- Shop & Compare Tools Part D Rx
- Get Instant Quotes, Information & Enroll online
- MANDATED wording!: ‘‘We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE to get information on all of your options.’’ § 422.2267(e)(41).
- We disagree with the above wording, as we can use the same tools on Medicare.gov as they do!
Extra Help
Extra Help with Medicare Prescription Drug Costs
Social Security Handbook
LIS Low Income Subsidy – Extra Help Levels
Income & Assets Charts 2022
- Source CMS LIS Memo 10.25.2021
- See also Your Guide to Medicare Drug Coverage Extra Help Section
- Medi-Cal (for People with Medicare) – 04-19-23
#Understanding Medicare Advantage Plans (PDF) #12026
- MAPD Plans look like a great deal, as the "premium" is paid by fee from the Federal Government, on average $2k/year.Kff * MAPD Plans must cover all A & B services Medicare.Gov * generally they also cover Part D Rx.
- That's why the premium is very low or ZERO!
- Set a Zoom Meeting
- We can now do SOC Scope of Appointment, before the Meeting via a 3 minute recorded meeting 2 days before. AHIP Training Module 4 Page 14 *
- #Intake Form Berwick Needs Assessment Form - We can better prepare for the meeting
- Medicare Advantage (Medicare Part C): An Overview Hi Cap
- HMO - Narrow Networks?
- HI Cap CA Health Care Advocates Fact Sheet
- Do I just sign up with a Medicare Advantage Company and automatically get * Parts A & B or do I have to get those from Medicare.Gov * VIDEO
- Get Quotes, Full Information and Enroll
- MANDATED wording!: Think Advisor * ‘‘We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE to get information on all of your options.’’
- We disagree with the above wording, as we can use the same tools on Medicare.gov as they do!
- FYI a 4.27.2022 HHS Office of the Inspector General report found that MAPD plans denied 13% of prior authorizations that would have been covered under original Medicare (Conversely, Medi Gap, just follows what Medicare pays.)
- 88% of MAPD enrollees are happy
-
MAPD plans often include Dental & Part D - Rx Prescriptions and often have NO premiums!
-
How is that possible?
-
The Federal Government pays them around $700/month to handle your medical care. You must continue to pay your Medicare Part B premium of about $170/month. It's best to apply when you turn 65 for the supplement plans or advantage plans, as that's the main "Open Enrollment" period, guaranteed issue for any plan.
-
-
-
Medicare Advantage Plans also have an annual open enrollment now known as AEP Annual Election Period October 7 to December 15th.
-
Additional Coverage is important as Medical Bills are increasing Seniors Credit Card Debt or leading to possible bankruptcy?
- If You Have Problems with Your Medicare Advantage Plan
- forbes.com/how-insurers-can-navigate-the-costs-of-medicare-advantage-benefits
- politico.com/medicare-advantage-plans-congress
- Uncle Sam wants you to help stop insurers' bogus Medicare Advantage sales tactics
- ca health advocates/using-ai-to-deny-care
- Dodging the Medicare Enrollment Deadline Can Be Costly
- Medicare Advantage Increasingly Popular With Seniors — But Not Hospitals and Doctors
- Medicare Advantage is bad for patients and bad for investors
- When Medicare Advantage Plans Terminate Coverage
- Medi-Cal D-SNP Feasibility Study
Medicare Savings Program MSP
Have Medi Cal pay Medicare Part B $174 Premium #Costs # 10126
Medi Cal * Part B Outpatient Premium Forgiveness
- How the ‘Medicare Cliff’ is raising costs and worsening health for many older low-income adults
- Medicare.Gov MSP Medicare Savings Programs
- DUALLY ELIGIBLE BENEFICIARIES UNDER MEDICARE AND MEDICAID (Medi Cal) MLN Knowledge Booklet
- cms.gov/QMB Qualified Medicare Beneficiary Programs
- Minimum Federal Eligibility Requirements for Medicare Savings Programs in 2024
- Save money on your Medicare costs
- CA Department of Aging 1-800-434-0222 -
- Medicare Counseling HICAP State Health Insurance Assistance Programs SHIP
- FACT Sheet Low Income Assistance: Medicare Savings Programs CA Health Care Advocates HI CAP
- Medicare Savings Programs in California
- health care rights.org Serving Los Angeles County
- dpss.lacounty.gov/savings
- Disability Benefits 101
- National Council on Aging MSP
- MSP Medicare Savings Plan CA Health Care Advocates
- khn.org/billions-of-dollars-in-benefits-go-unused
- Our webpage on Part D Rx Extra Help - LIS Low Income Subsidy
- Explanation of countable Income Insure Me Kevin.com
- FAQ
- Will the Aged & Disabled program pay for Medicare Part B Outpatient & Doctor Visits premium of $174?
- See brochure above.
.
- See brochure above.
- Medicare I need help with choosing what my options are.
- Take a look at our webpage on Original Medicare A & B plus Part D Rx and Medi Gap vs Medicare Advantage
- Set up a Zoom Meeting and we can discuss. www.SteveShorr.com/Meeting
- Will the Aged & Disabled program pay for Medicare Part B Outpatient & Doctor Visits premium of $174?
#Medicare10050 and You 2025
Everything you want to know
- Steve's Video Seminar Introduction to Medicare & You
- 2025 Changes & Updates CA Health Care Advocates 78 page slide show pdf
- Clear View to Medicare Patient Advocate.org - 36 pages
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- Your Medicare #Benefits # 10116
- Inpatient ONLY - How Medicare Pays for your Surgery Part A vs Part B Very Well Health.com
- medicare.gov/coverage
- What's Covered App for Smartphones
- Medicare Coverage Database Search
- medicare.gov/procedure-price-lookup
- MLN Items & Services Not Covered Under Medicare
- An Overview-05-19-23 CA Health Care Advocates Hi Cap
- Original Medicare: An Overview CA Health Care Advocates Hi Cap
- 2024 Premiums, Coinsurance & Deductibles – 10-19-23 CA Health Care Advocates Hi Cap
- Supplementing Medicare: An Overview 10-30-20 CA Health Care Advocates Hi Cap
- Enroll in Blue Cross
- Learn about UHC United Health Care
- Enroll in Blue Shield
- SCAN
- Use our scheduler to Set a phone, Skype or Face to Face meeting
- #Intake Form - We can better prepare for the meeting (National Contracting Center)
- TITLE XVIII—HEALTH INSURANCE FOR THE AGED - Medicare AND DISABLE
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- Welcome to Medicare 2022 Publication # 11095
- Our webpage on Enrolling ONLINE for Medicare Part A Hospital & B Doctor Visits
- Part A Hospital rules for zero premium
- Part B – Doctors – How to sign up – Benefits
- How to apply for Part B when you lose employer coverage - during your special enrollment period # 10012
- Fact Sheet Deciding Whether to Enroll in Medicare Part A and Part B When You Turn 65 CMS.gov 15 pages
- Medicare & You: Deciding to Sign Up for Medicare Part B VIDEO
- CMS form to fill out L 564 E to prove you had Employer Coverage and get a special enrollment period, when you retire. VIDEO
- HI CAP CA Health Care Advocates Medicare Enrollment Periods
FAQ's from Medicare.Gov
#Should I get Parts A & B?
Most people should enroll in Medicare Part A (Hospital Insurance) when they're first eligible, but certain people may choose to delay Medicare Part B (Medical Insurance). In most cases, #How
It depends on the type of health coverage you may have.
- Deciding to Sign Up for Medicare Part B VIDEO
- You must pay your Part B premium every month for as long as you have Part B (even if you don’t use it).
- If I'm low income - are there any breaks?
- Interactive Q & A from IRS on when to sign up for Medicare
- I have coverage through my spouse who is currently working.
- I have retiree coverage (from my former employer or my spouse’s former employer) or COBRA coverage.
- I have TRICARE, and I'm a retired service member.
- I have TRICARE, and I'm an active-duty service member.
- I have CHAMPVA.
- I have End-Stage Renal Disease (ESRD).
- I have Marketplace Covered CA or other private insurance.
- I don't have any of these.
- medicare.gov/should-i-get-parts-a-b
- How to apply for Part B during your special enrollment period # 10012
- Fact Sheet Deciding Whether to Enroll in Medicare Part A and Part B When You Turn 65 15 pages
- FAQ's that we did
Links & Resources
- My Advocate Helps Save money, engage with your community, and improve your health. Take advantage of the different programs in your area. My advocate makes it easy to find programs that fit your life.
- CA Health Advocates.org on LIS/Extra Help
- Hi Cap Medicare Counseling ca health advocates.org/hicap/
- Federal Poverty Level Chart
- 4 Ways to Help Lower your Medicare Prescription Drug Costs # 11417
- LA Times 8.10.2014 Tips to save $$$
- Jewish Free Loan Assoc.
- The Implications Of Rutledge v. PCMA For State Health Care Cost Regulation
#My Medi-Cal
How to get the Health Care
You Need
24 pages
Smart Phones - try turning sideways to view pdf better
-
- More explanation
- Enroll with Benefits Cal
- What is Medi Cal - VIDEO
-
Medi-Cal Managed Care HMO – Health Care Options
Here you can review and choose the HMO that you want to deliver your Medi-Cal health Care.
- California Advancing and Innovating Medi-Cal (CalAIM) is a long-term commitment to transform and strengthen Medi-Cal, offering Californians a more equitable, coordinated, and person-centered approach to maximizing their health and life trajectory.
- Medicaid.gov
- Disability Benefits 101
- Western Poverty Law Center Guide
- Medi-Cal enrollees not sure how to use coverage california health line.org
- Medi Cal only covers outside of CA for emergencies and very special circumstances. Cornel Law *
- Medi-Cal pays $415 to $575/month or MORE to HMO’s to take care of you Learn More⇒ Insure Me Kevin.com 3.4.2016 5.11.2014
- Medi Cal Explained CHCF
- Medi-Cal Facts and Figures, 2024 Edition Gives a lot of information on ALL Health Insurance Programs
- Medi Cal Contact Information
- chcf.org/cal aim-resources-
- cal matters.org/medi-cal-eligibility/
- dhcs.ca.gov/Budget-Highlights
- ebudget.ca.gov/Full Budget Summary
-
Prescription drugs.
-
- Hearing Aid Cap FAQ's
- Health screenings for kids
- Preventive and wellness services and chronic disease management.
-
- Mental Health CHCF Fact Sheet
- Substance abuse CHCF Article
- Maternity
Ongoing Care & Recovery
- Personal care services (IHSS)
- Nutrition Food & Meals
More Details
- My Medi-Cal brochure
- dhcs.ca.gov/Medi-Cal_EHB_Benefits
- dhcs.ca.gov/Benefits_services.aspx
- dhcs.ca.gov/Benefits-Chart
- Check with your HMO Providers Evidence of Coverage
- Insure Me Kevin.com - Medi Cal HMO same coverage as Covered CA HMO! Provider list may differ!
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- Our Webpages on
- Medi Cal Choose HMO PCP Doctor & Insurance Company
- Denti Cal
- Medi-Cal – MAGI Income Eligibility Criteria
-
BIC Benefits Identification Card
https://www.bloomberg.com/news/articles/2024-10-01/humira-cost-slashed-as-california-insurer-bypasses-drug-fees
https://www.aarp.org/politics-society/advocacy/info-2023/extra-help-medicare-part-d-prescriptions.html
https://edition.pagesuite.com/popovers/dynamic_article_popover.aspx?guid=1128d6a1-1c95-4793-b67e-1abad110c5d0&v=sdk
https://khn.org/news/article/the-pill-club-reaches-18-3-million-medicaid-fraud-settlement-with-california/
https://www.goodrx.com/insurance/health-insurance/prescription-insurance-vs-medical-insurance
https://www.pharmacy.ca.gov/consumers/medicare_discount.shtml
Good Rx can’t be used if you have a Part D Rx plan???
Good Rx is a front for MAPD marketing?
https://www.needymeds.org/
https://healthpayerintelligence.com/news/63-of-medicare-beneficiaries-paid-full-generic-drugs-cost-in-2020