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Limited Income Net Program

Access forms, manuals and other pharmacy reference material related to our Limited Income NET program.

Limited Income NET Program and Humana

Effective January 1, 2010, Humana will begin administering the Limited Income NET Program for the Centers for Medicare & Medicaid Services (CMS). This program allows certain individuals with the Low Income Subsidy (LIS) to receive immediate need coverage at the point-of-sale if they are not already enrolled into a Part D plan. Additionally, CMS will temporarily enroll newly identified individuals with Medicare and Medicaid, (Dual-Eligibles) into the Limited Income NET Program contract (contract number X0001). This allows for a smoother transition as CMS autoenrolls them into standard Medicare prescription drug plans. Limited Income NET Program replaces the WellPoint Point-of-Sale Facilitated Enrollment (POS FE) process.

Limited Income NET Program Forms

Pharmacy Fax Request
Pharmacy Fax Request to Humana For Limited Income Newly Eligible Transition Claims Over 30 Days Old.
(101 KB) Download PDF
English
Limited Income NET Program Payer Sheet
A Document that explains in detail how to submit Limited Income NET Program claims.
(0.2 MB) Download PDF
English
Limited Income NET Program Payer Sheet for NCPDP version D.0
A Document that explains in detail how to submit Limited Income NET Program claims.
(575 KB) Download PDF
English
Four Steps for Pharmacists
View and Download the Limited Income NET Program 4 Steps Document.
(0.2 MB) Download PDF
English

Limited Income NET Program Resources

Announcement for Parts 1 and 2
Information on home study course
(52 KB) Download PDF
English
Announcement for Part 3
Information on home study course
(41 KB) Download PDF
English
Limited Income NET Program Question & Answers
A list of frequently asked questions regarding Limited Income NET.
(0.2 MB) Download PDF
English
Limited Income NET Program Tip Sheet for Pharmacy Providers
A document that offers pharmacists additional guidance on using the Limited Income NET program.
(0.2 MB) Download PDF
English
Limited Income NET Program for People at the Pharmacy Counter
(145 KB) Download PDF
English
The Limited Income NET Program for People With Retroactive Medicaid & SSI Eligibility
(150 KB) Download PDF
English
Beneficiary letter
This letter is mailed to individuals who have qualified for the Limited Income (LI) Newly Eligible Transition (NET) Program.
(21 KB) Download PDF
English
Factsheet
This document is mailed with the beneficiary letter and provides additional information about the Limited Income NET Program.
(40 KB) Download PDF
English
Limited Income NET Program Quick Reference Guide
This brochure offers a quick reference regarding the Limited Income NET Program.
(40 KB) Download PDF
English

The Limited Income NET Program Survey

Please fill out this survey designed to obtain feedback from your experience with and knowledge of the LI NET Program.