Medicare’s Limited Income Newly Eligible Transition (LI NET) program is designed to provide temporary prescription drug coverage for low-income beneficiaries who are eligible for Medicare Part D but have not yet enrolled in a plan. And, if they have been paying out-of-pocket for prescriptions, to be able to be retroactively reimbursed up to 60 days. The program ensures these individuals have access to the medications they need, without delay or financial burden. Recently, the Centers for Medicare & Medicaid Services (CMS) announced several changes to the LI NET program, aimed at streamlining the process and increasing access to coverage. Let’s see how the LI NET program works, who is eligible, and what you need to do to get started.

How the LI NET Program Works

The LI NET program, which is administered by Humana, provides immediate, temporary prescription drug coverage for low-income Medicare beneficiaries who have not yet enrolled in a Part D plan. Once enrolled, beneficiaries receive a temporary Humana ID card, which they can use at any participating pharmacy to fill their prescriptions. The program covers most Medicare Part D drugs, with minimal copayments.

The recent changes to the program focus on simplifying the enrollment process and ensuring that beneficiaries are transitioned smoothly to a permanent Part D plan. The updated process automatically enrolls eligible individuals in the LI NET program once they become eligible for Medicare Part D. Additionally, CMS will now actively assist beneficiaries in finding and enrolling in a permanent Part D plan that best suits their needs.

Who is Eligible

The LI NET program is intended for low-income individuals who meet the following criteria:

1. Are eligible for Medicare Part D.
2. Have not yet enrolled in a Part D plan.
3. Have an income below 150% of the Federal Poverty Level.
4. Are not receiving assistance from a state pharmaceutical assistance program.

To be eligible for the program, individuals must also be U.S. citizens or lawfully present in the United States.

What You Need to Do

If you believe you are eligible for the LI NET program, follow these steps:

1. Check your eligibility: Call your insurance agent, who can check your eligibility very quickly. If you don’t have an agent, you can contact your local Social Security office to verify your eligibility for Medicare Part D and the LI NET program.
2. Apply for Extra Help: Extra Help is a Medicare program that assists low-income beneficiaries with paying for prescription drug costs. Your agent can help you apply. Again, if you have no agent, visit the Social Security Administration’s website (ssa.gov) or contact your local Social Security office.
3. Obtain your temporary Humana ID card: If you are automatically enrolled in the LI NET program, you will receive a temporary Humana ID card in the mail. If you have not received your card, contact Humana at 1-800-783-1307.
4. Use your temporary Humana ID card: Present your temporary Humana ID card at any participating pharmacy to fill your prescriptions. Be aware you will be responsible for a small copayment.
5. Enroll in a permanent Part D plan: Speak to your agent about enrolling in a Part-D plan right away. It is crucial to enroll in a plan as soon as possible to avoid any gaps in coverage once your temporary LI NET coverage ends.

The recent changes to the Medicare Limited Income Newly Eligible Transition program aim to simplify the enrollment process and improve access to prescription drug coverage for low-income beneficiaries. By understanding the program, checking your eligibility, and following the necessary steps, you can ensure that you receive the support you need to access essential medications.