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LI NET—Beneficiary resources
LI NET is a Medicare program that provides immediate prescription coverage for Medicare beneficiaries who qualify for Medicaid or ”Extra Help” and have no prescription drug coverage.
Enrollment in LI NET is temporary, usually for 1 to 2 months. As a beneficiary, this temporary coverage provides you with adequate time to choose a Medicare Part D prescription drug plan that best fits your needs. If by chance, you do not select a plan within this timeframe, Medicare will automatically enroll you into a benchmark plan.
Coverage for out-of-pocket expenses during eligible periods (retroactive coverage) is also available by submitting a direct member reimbursement form.
How can the LI NET program help me?
Imagine you’re at a pharmacy counter, and you need your prescription filled. You’ve signed up for Medicare Part D drug coverage, and you qualify for ”Extra Help,” but your Part D coverage hasn’t started yet.
The LI NET program provides immediate prescription drug coverage for people in your situation. LI NET covers all Part D drugs and there are no network pharmacy restrictions during the time period you are covered by this program.
Note: LI NET does not cover drugs excluded from the Part D program.
How do I know if I’m eligible?
Eligibility requirements for the LI NET program include:
- Medicare and Part D eligibility
- Eligible for ”Extra Help,” including any of the following:
- Full-benefit dual-eligible beneficiaries: those with Medicare and full Medicaid benefits
- SSI-only beneficiaries: those with Medicare who receive Supplemental Security Income (SSI) but do not have Medicaid
- Partial-benefit dual-eligible beneficiaries: those with Medicare who qualify for Medicare Savings Programs (MSP) but not full Medicaid, i.e., QMB Only, SLMB Only and QI
- “Extra Help” applicants: those who have applied for, and have been awarded, “Extra Help” through SSA or their state
- Have no other prescription coverage, including:
- Part D plan coverage
- Retiree drug subsidy (RDS) plan
- VA coverage
- Not enrolled in a Part C plan, which does not allow concomitant enrollment in a Part D plan
- Not opted out of auto-enrollment
- Have a permanent address in the fifty States or DC
If I’m eligible, what do I do next?
- Be on the lookout for your welcome letter with important plan information from LI NET.
- If you have not received your welcome letter and need a prescription filled:
- Take your prescription and Medicare ID card to your pharmacy.
- Ask the pharmacist to submit your claim to LI NET using the following:
BIN:015599 PCN: 05440000
Note: If you have additional questions, call the LI NET help desk at 800-783-1307 (TTY: 711), Monday – Friday, 8 a.m. – 7 p.m., Eastern time.
- Submit a receipt. If you’ve already paid out-of-pocket for prescriptions during eligible LI NET periods, you can submit your receipt for reimbursement.
State Health Insurance Assistance Programs (SHIPs): 877-839-2675
Social Security Administration: 800-772-1213 (TTY: 800-325-0778)
Medicare Rights Center: 888-466-9050