Medicare’s Limited Income NET Program

The Limited Income NET Program (or LI NET) is designed to eliminate any gaps in coverage for low-income individuals transitioning to Medicare Part D drug coverage.

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 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.

LI NET Tutorial with Free Continuing Education Credit

Limited Income NET Tutorial 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.

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 and 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