Point-of-sale prescription drug coverage
The LI NET Program ensures that individuals with Medicare’s low-income subsidy (LIS), or “Extra Help,” who are not yet enrolled in a Part D prescription drug plan are still able to obtain immediate prescription drug coverage. If an individual is later determined to be ineligible because he/she does not receive the LIS, the individual will be financially responsible for any claims already paid on his/her behalf.
Retroactive prescription drug coverage
The LI NET Program provides retroactive coverage for new dual eligibles (those individuals who are eligible for both Medicare and Medicaid or Medicare and Supplemental Security Income (SSI) from the Social Security Administration (SSA)). Medicare automatically enrolls these individuals into the LI NET Program for eligible periods with an effective date retroactive to the start of their full-benefit dual eligible status. Enrollment in the LI NET Program is temporary until Medicare enrolls these individuals in a standard Medicare Part D plan for the future.
Frequently Used Program Resources
Limited Income NET Program Brochure
This brochure offers an overview of Medicare’s Limited Income NET Program and key contact information.
Four Steps for Pharmacy Providers
This flier provides an overview of Medicare’s Limited Income NET claim submission process for pharmacy providers.
Limited Income NET Program Payer Sheet for NCPDP version D.0
This document provides detailed information on the claim submission process using National Council for Prescription Drug Programs (NCPDP) Telecommunication Standard Version D.0.
Limited Income NET Program Question & Answers
This document offers answers to frequently asked questions about Medicare’s Limited Income NET Program.
Additional Forms and Resources for Pharmacy Providers
Pharmacy Fax Request
Fax form for Limited Income NET claims more than 30 days old
Limited Income NET Program Tip Sheet for Pharmacy Providers
Basic overview of the Limited Income NET program
Limited Income NET Program for Pharmacy Staff
A CMS resource providing an overview of the Limited Income NET Program
The Limited Income NET Program for People With Retroactive Medicaid & SSI Eligibility
A CMS tip sheet
Resources for Beneficiaries
Beneficiary Letter
A letter mailed to individuals who have qualified for Medicare’s LI NET Program
Factsheet
An overview of the Limited Income NET Program for beneficiaries
The Medicare Limited Income NET Program Survey
Please complete this survey based on your experience with and knowledge of Medicare’s LI NET Program.
Survey for Pharmacy Providers
Survey for All Other Stakeholders
