Wednesday, February 1, 2023

Social Security Low Income Subsidy

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What Information Is Received From The Social Security Administration On The Low Income Subsidy File

Low Income Subsidy and Extra Help Through Social Security | SES Senior Enrollment Solutions

The LIS interface file contains the demographics, income and partial resource information pertaining to clients who are just becoming eligible for Medicare. It also provides information for:

  • Clients who are reaching their 24th month of disability, and
  • Medicare Savings Program clients moving into the State and who have completed an LIS application.

Whom Does Social Insurance Benefit


Eligibility varies widely for programs depending on a programs goals, target population, and administration. The target population might be people with work records, current workers, children, families with children, people with disabilities, people who are age 65 and older, people with low incomes, pregnant or nursing women, or some combination of these groups.

Applicants to programs such as Social Security, Medicare, and UI need work records of varying lengths to qualify. These programs do not have an income eligibility limit and are often referred to as universal, though they do require a specified number of quarters or years of paid employment. A few programs require a beneficiary to have earned income the EITC is a leading example. Other programs require incurring a particular type of expense, such as child-care costs.

Various programs also set other eligibility conditions or restrictions. UI requires beneficiaries to search for jobs. For TANF participants and some SNAP and housing assistance participants, time limits are imposed on participation unless they are meeting a work requirement. For SNAP, states can secure waivers from this time limit for areas with elevated unemployment and can provide individual exemptions. Several other programs allow states to restrict eligibility further, to exclude people such as ex-felons or people found to be using banned substances.

Eligibility among Immigrants

Participation and Take Up


What Was The Challenge

The Social Security Administration conducts outreach to Medicare beneficiaries who may qualify for Medicare cost-sharing assistance under the Medicare Savings Programs and for the Medicare Part D Low-Income Subsidy . In May of each year, SSA mails the Social Security LIS and MSP Outreach Notices to individuals who may be eligible for both the MSP and Extra Help , and those who already have Extra Help and may also be eligible for the MSPs , to inform them of the potential cost savings and how to apply. The major objective of this outreach is to increase enrollment of eligible low-income individuals into these programs.

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Extend Ssi To The Us Territories

Among the territories, only residents of the Northern Mariana Islands receive SSI. Puerto Rico, Guam, and the Virgin Islands receive a federal block grant called Aid to the Aged, Blind, and Disabled , which provides far lower benefits and has more restrictive eligibility criteria than SSI. American Samoa has neither SSI nor AABD.

AABD is much more restrictive than SSI. Unlike with SSI, federal law caps the annual funding that the territories receive for AABD and other adult assistance programs, and that cap hasnt changed since 1997. A GAO study estimated that in 2011, federal spending on AABD was less than 2 percent of what it would have been if Puerto Rico residents received full SSI benefits, and that monthly benefits for an individual receiving AABD are less than 15 percent of the benefits that SSI would provide, all else being equal.

Puerto Ricos exclusion from SSI is especially harmful given the territorys high disability rate. Disability is more prevalent among less educated, lower-income, and older people, and these are more likely the case for Puerto Rico residents than mainland U.S. residents. Nearly 1 in 6 Puerto Rico residents are disabled, according to the Census Bureau, compared to 8.6 percent of the general U.S. population, and half of the territorys disabled residents live in poverty twice the U.S. average. Most territories have overwhelmingly non-white populations, giving this exclusion a racially disparate impact.

Improve Ssis Treatment Of Immigrants

What is the low

Until the 1996 welfare law, immigrants with low incomes who were lawful permanent residents generally qualified for SSI on the same basis as U.S. citizens. Now, most lawful permanent residents who are elderly or have disabilities are ineligible for SSI . Even immigrants who are lawfully present and who acquire a disability after entering the U.S. are ineligible. SSIs immigration-related eligibility restrictions are much harsher than those imposed by SNAP, Medicaid, and TANF, and they cause considerable hardship. More than 4 in 5 immigrants are people of color, giving these restrictions a racially disparate impact.

Policymakers should end the harsh immigration-related restrictions and allow people with lawful immigration statuses to be eligible for SSI on the same basis as U.S. citizens.

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Social Security Low Income Subsidy

Social Security Low Income Subsidy, also known as Extra Help, is for anyone who has Medicare and Prescription drug coverage.

This program is available for some people with limited income and resources. It will pay for all or most of the monthly premiums and annual deductibles and lower the prescription co-payments related to their plan. The Extra Help is estimated to be worth an average of $3,900 per year. To find out if you are eligible, Social Security will need to know your income and the value of your savings, investments and real estate . Requirements for 2017 to qualify for Low Income Subsidy are as follows :

1. Income limited to $18,096 for an individual or $24,360 for a married couple living together.2. Resources limited to $13,820 for an individual or $27,600 for a married couple living together. Resources include such things as bank accounts, stocks and bonds. A house and car are not counted as resources.

For more information call Social Security toll free at 1-800-772-1213 or visit

How Do I Access The Low Income Subsidy Screens

To access the LIS application file take the following steps:

  • From the WMEN screen, select Option – File Inquiry.
  • On the LMEN screen, complete the following fields:
    • Selection field – Enter – LIS Application.
    • Client SSN field – Enter the , or
    • Client ID field – Enter the .
  • < TRANSMIT> and the LIS1 screen displays the clients demographics data and the LIS approval details.
  • To access the LIS2 screen by pressing < F14> . The LIS2 screen displays the earned income, unearned income and resources of the client and the spouse as reported to the Social Security Administration .
  • The LIS data can also be accessed from the UNER and the EARN screens.

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    What Is The Medicare Extra Help Program

    The Medicare Extra Help Program is a federal program thats designed to help those who have limited income and resources pay for Medicare prescription drug program costs, such as premiums, deductibles and coinsurance payments, says Robin Saks Frankel, Personal Finance Expert of Forbes Advisor. Under the Medicare Extra Help Program, you also wont need to pay the Part D late enrollment penalty that is imposed for not enrolling in a prescription drug plan when youre first eligible.

    When you receive Extra Help, your drug plan ensures you never pay more than the Low Income Subsidy coverage cost limit. In 2022, this is no more than $3.95 for each generic or $9.85 for each brand-name covered drug, Saks says.

    Who Might Need Help With Their Lis

    What is the Low Income Subsidy Program? (LIS)

    There are 4 groups of people who already have the LIS, but may need some help to keep it or to understand that their LIS is changing. We send them targeted notices on colored paper when there are changes to their LIS.

    1. People who wont automatically be eligible for the LIS

    Each September, we mail a notice on gray paper to people wholl no longer automatically get the LIS. This notice is a LIS application, and it includes a postage-paid pre-addressed envelope. These people may still qualify for the LIS, but they will need to send in a new application. The gray notice:

    • Tells the person why they no longer automatically qualify for the LIS
    • Encourages them to fill out and send in a LIS application

    2. People wholl have a change to their LIS co-payment

    In early October, we mail a notice on orange paper to people wholl qualify for extra help, but will have a change to their co-payment.

    3. People wholl be reassigned to a new plan

    In early November, we mail a notice on blue paper to people who qualify for the LIS, but will be reassigned to a new prescription drug plan starting on January 1st.

    We automatically reassign people who:

    • Qualify for the full premium subsidy
    • Are in a prescription drug plan thats raising the premium above the low-income premium amount
    • Were enrolled in their current plan by CMS

    Well also automatically reassign people who qualify for the LIS, if their prescription drug plan leaves the Medicare Program.

    4. People who chose their plan

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    What Should A Member Do If They Get This Notice

    Keep the LIS Rider notification with your important papers, so you can refer to it if you have questions about your costs. Medicare or the Social Security Administration will periodically review a member’s eligibility to make sure the member still qualifies for Extra Help with Medicare prescription drug plan costs. Eligibility for Extra Help might change if there is a change in the member’s income or resources, if a member gets married or divorced, or if the member becomes ineligible for Medicaid benefits. The member will be notified if her or his status changes.

    If you have any questions about your LIS Rider notification, please call Member Services at 1-800-794-5907 . From October 1 – March 31, we are open 7 days a week, 8 a.m. to 8 p.m. From April 1 – September 30, we are open Monday – Friday, 8 a.m. to 8 p.m. You may always leave a voicemail after hours, Saturdays, Sundays, and holidays and we will return your call within one business day.

    You must continue to pay your Medicare Part B premium. The Part B premium may be covered through your state Medicaid program.

    Benefits, premiums, and/or member cost-share may change on January 1 of each year.

    Labour Market Policies And Interventions

    Labour market policies and interventions provide protection for poor people who are able to work and aim to ensure basic standards and rights . These government-led policies and interventions can be contributory or non-contributory, active , or passive .

    Active labour market policies and interventions aim to help the unemployed and the most vulnerable find jobs. Traditionally, this includes interventions such as matching jobseekers with current vacancies upgrading and adapting jobseekers skills providing employment subsidies and creating jobs either through public sector employment or the provision of subsidies for private sector work . In high-income countries, such policies mostly extend to formal workers. In developing countries with labour markets characterised by higher informality and lower unemployment than in higher-income countries active labour market policies often include anti-poverty measures and blend interventions . For example, training programmes may be accompanied by public works and some type of income support, or employment subsidies may be aimed at hiring participants targeted by cash transfer programmes who are at risk of poor labour market outcomes such as underemployment and/or informality . There is sometimes an overlap in classifying active labour market activities with public works and graduation programmes.

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    The Social Insurance System In The Us: Policies To Protect Workers And Families

    This paper examines the U.S. social insurance system, which we define broadly to include both programs supported by dedicated taxes and other federal programs that provide income support, assistance in meeting basic needs, or services to improve economic opportunity. The paper considers the social insurance system as a whole as well as its component parts, providing an overview of major federal programs in the areas of education and workforce development, health, income support, nutrition, and housing. The paper covers how the social insurance system is organized, how eligibility is determined and who benefits, how the benefits and services are delivered, and how the system affects poverty and inequality. We focus primarily on the system as it operated prior to the onset of the COVID-19 pandemic, but also look at how various programs respond to economic downturns. Coming at a time when policymakers will start shifting their focus from using the social insurance system to provide relief from the pandemic and recession to considering what changes should be made in the system on an ongoing basis, the paper also reprises an array of proposals to strengthen the system in various ways that The Hamilton Project has commissioned in recent years.

    Update Ssis Income Exemptions

    Trump, House Republican Cuts to SSI Would Harm Children With ...

    Similar to the asset limit, SSIs general income exclusion and earned income exclusion have declined dramatically in value.

    SSI exempts the first $20 per month of unearned income when determining a persons eligibility and benefit levels any income above that amount from sources such as Social Security, pensions, interest, and child support is subtracted from SSI benefits. Similarly, SSA disregards the first $65 per month of earnings each $1 of earnings above that level reduces SSI benefits by 50 cents. These rules begin to reduce benefits even when a recipients income is well below the poverty line. The amount of income that SSA disregards when calculating SSI benefits has not changed, even to account for inflation, since 1972. That has increasingly eroded the inflation-adjusted value of benefits for SSI recipients who work or receive Social Security or other income. For SSI beneficiaries who can work, the stringent disregard for earned income significantly diminishes any incentive to work. The dollar-for-dollar benefits reduction for non-wage income above $20 does little to reward those who receive Social Security based on their past work, since the combined benefits that they receive are little different than the benefits received by those with no work history.

    Treat Social Security as Earned Income

    Social Security income, which people earn by working and contributing payroll taxes, should be considered earned income.

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    Eliminate Ssis Marriage Penalties

    SSI penalizes recipients who marry one another. The asset limit is $2,000 per individual but $3,000 for a married couple. Similarly, the federal benefit is $841 for an individual and $1,261 for a married couple in 2022, costing a married couple up to about $400 a month.

    Policymakers should eliminate the marriage penalties by making the asset test and federal benefit for married couples twice that of individuals, as both the SSI Restoration Act and Biden campaign plan would do. They also should end the holding out rule, which requires extensive questioning to determine if couples who are not legally married are presenting themselves to the community as a married couple. This rule subjects SSI recipients to intrusive scrutiny of their personal lives.

    How Am I Notified When There Is A Discrepancy Between The Information In Aces Versus What Is Sent On The Low Income Subsidy File

    Alerts are generated to the worker of record unless the client’s has an out of state zip code or doesn’t match the zip code in ACES. These Assistance Units are assigned to CSC 128 -District 2 Customer Service Center and the default user.

    When there is a discrepancy in the Social Security Number, name or date of birth between the LIS Application file and ACES, a two-tier discrepancy Alert 430 – LIS MATCH DISCREPANCY – REVIEW FOR MSP PROGRAM is generated.

    When ACES receives a record with a date of death for a spouse, a two-tier discrepancy Alert 431 – SPOUSE IN THE LIS FILE DECEASED PER ACES generates and spouse isn’t added to the pending Qualified Medicare Beneficiary AU.

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    What Happens When Aces Does Not Auto

    An S03 AU is not auto-screened under the following conditions:

    • If there is a discrepancy in the clients name, date of birth or Social Security Number between ACES and the Low Income Subsidy file.
    • Alert 430 – LIS MATCH DISCREPANCY – REVIEW FOR MSP PROGRAM is generated. The second line of this alert identifies the discrepancy for the worker to review and take the appropriate case action.
  • If the client is deceased per ACES coding.
  • If the client is active or pending on a S03 AU.
  • If the LIS file contains a spouse or other household members that aren’t already known to ACES, Alert 247 – SDX SHOWS CLIENT MARRIED, ACES DOES NOT is generated to the user of record to review household composition.
  • When auto-screen is not possible, an S03 AU should be manually screened if appropriate.

    What To Know About Medicare Extra Help:

    Medicare Low Income Subsidy Explained
    • The Medicare Extra Help Program, also called the Part D Low-Income Subsidy, helps Medicare beneficiaries with low income and resources pay for the cost of their prescription drugs and prescription drug coverage.
    • To qualify for Extra Help, you must be on Medicare and living in the U.S. with income and financial resources below a certain annual threshold.
    • Many people may qualify for Extra Help without realizing it.
    • You can apply for the Medicare Extra Help Program through the Social Security Administration online, over the phone or in-person, when restrictions allow.

    The Medicare Extra Help Program, also called the Part D Low-Income Subsidy, helps Medicare beneficiaries with low income and resources pay for the cost of their prescription drugs and prescription drug coverage. This benefit is worth an estimated $5,000 per year, according to the Social Security Administration.

    Many people may qualify for Extra Help without realizing it. To qualify for Extra Help, you must be on Medicare Part A and/or Part B and living in the U.S. with income and financial resources below a certain annual threshold. Here we explain what the Extra Help Program is, who qualifies and how to apply if you do.

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