LI NET resources for members and advocates

LI NET is a Medicare program that provides immediate prescription drug coverage for Medicare beneficiaries who have no prescription drug coverage and who qualify for Medicaid or Extra Help.  

Enrollment in LI NET is temporary, usually for 1 to 2 months. LI NET gives beneficiaries time to choose a Medicare Part D prescription drug plan that best fits their needs. If an eligible member doesn’t select a plan during that time, Medicare will automatically enroll them in one.

Who is eligible for LI NET?

Beneficiaries must be eligible for Medicare Part D, qualify for Medicaid or Extra Help and have no other prescription drug coverage. This includes:

• Full-benefit dual-eligible beneficiaries: those with Medicare and full Medicaid benefits
• Partial-benefit dual-eligible beneficiaries: those with Medicare who qualify for Medicare Savings Programs (MSP) but not full Medicaid, which includes: 
  • Qualified Medicare Beneficiary (QMB) only
  • Specified Low-Income Medicare Beneficiary (SLMB) only
  • Qualifying Individuals (QI) 
• SSI-only beneficiaries: those with Medicare who receive Supplemental Security Income (SSI) but do not have Medicaid
• Extra Help applicants: People who have applied for Extra Help through Social Security and received a Notice of Award letter 

Beneficiaries must:

• Not have other prescription drug coverage such as:
  • Part D plan coverage
  • Retiree Drug Subsidy (RDS) plan 
  • Veterans Affairs (VA) coverage 
  • Medicare advantage plan that prohibits enrollment in a standalone Medicare part D prescription drug plan
• Not have opted out of auto-enrollment in a Medicare Part D plan
• Not be incarcerated 
• Be lawfully present in the U.S 
• Have a permanent address within the 50 states or Washington, D.C.

How does someone enroll in LINET?

• Those eligible for Medicare & Medicaid (full-benefit dual-eligible beneficiaries) are automatically enrolled in LI NET. They will receive a letter on purple paper from CMS indicating they are deemed eligible for Extra Help and opted in to LI NET.
• People who are partially dual-eligible and those who applied directly for Extra Help can enroll at their pharmacy by taking their prescription and Medicare ID card and asking the pharmacist to submit the claim to LI NET using the following: 
  • BIN: 015599
  • PCN: 05440000
  • Cardholder ID: Medicare Beneficiary Identifier (MBI) from the red white & blue Medicare card
• Questions regarding eligibility and claim submission can be directed to the LI NET service center 

Is there a premium for LI NET?

There is no monthly premium for LI NET.

Is there a copay for prescriptions?

Beneficiaries may have to pay a copay. If so, it will be based on their Extra Help level.

Can I use my pharmacy?

You can use any pharmacy with LI NET, since there are no network restrictions.

What medications are covered?

LI NET covers all drugs covered by Medicare Part D.

Does LI NET reimburse for out-of-pocket expenses?

If you’ve already paid out of pocket for prescriptions during eligible LI NET periods, you can submit your receipt for reimbursement using the form below.

Prescription Drug Claim Form for Member Reimbursement—English

Prescription Drug Claim Form for Member Reimbursement—Spanish