Medicare’s Limited Income NET Program
The Limited Income NET Program (or LI NET) is designed to eliminate gaps in coverage for low-income individuals transitioning to Medicare Part D 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 claims already paid on his/her behalf.
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.
Limited Income NET medications list (222 Kb)
This list highlights drug categories excluded from Medicare Part D coverage by law and drugs not payable under the program.
Low-income Subsidy Requirement (356 Kb)
Requirement for point-of-sale enrollment
Limited Income NET Program Brochure (823 Kb)
This brochure offers an overview of Medicare’s Limited Income NET Program and key contact information.
Four Steps for Pharmacy Providers (266 Kb)
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 (388 Kb)
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 (402 Kb)
This document offers answers to frequently asked questions about Medicare’s Limited Income NET Program.
Limited Income NET tutorial offering continuing education credit
This presentation will walk you through Medicare's Limited Income NET Program, and you can earn one hour of free continuing education credit for viewing it and completing a follow-up assessment.
Limited Income NET program immediate need fax (360 Kb)
A CMS fax cover sheet and claim submission form
Pharmacy Fax Request (108 Kb)
Fax form for Limited Income NET claims more than 30 days old
Limited Income NET Program Tip Sheet for Pharmacy Providers (480 Kb)
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
Beneficiary Letter (362 Kb)
A letter mailed to individuals who have qualified for Medicare’s LI NET Program
Factsheet (43 Kb)
An overview of the Limited Income NET Program for beneficiaries
Please complete this survey based on your experience with and knowledge of Medicare’s LI NET Program.