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How to use or fill out Low Income Premium Program - nmmip with our platform
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Click ‘Get Form’ to open the Low Income Premium Program application in the editor.
Begin by filling out the Applicant Information section. Enter your last name, first name, middle initial, address, city, state (NM), zip code, and ID number.
In the Premium Payment Certification section, certify that you or a family member will be paying your premiums. If a third party is paying, you are not eligible for LIPP.
Provide details about your household size and total annual income for all adults over 18 in your household. Use additional sheets if necessary.
Attach copies of previous year’s Federal Income Tax forms for each adult who had income. Complete and sign Affidavit A if applicable.
If any adult did not file a tax form but had income, complete Affidavit B and ensure it is notarized.
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Extra Help, Low Income Subsidy (LIS), program. Extra Help, or LIS, is a government program that helps cover prescription drug costs for certain eligible Medicare beneficiaries with limited incomes, including monthly premiums, annual deductibles, and prescription co-payments.
What is the Lis program with social security?
Specified Low-Income Medicare Beneficiary (SLMB) Program Your situation:Monthly income limit:*Resource limit: What counts in resource limits? Individual $1,585 $9,660 Married couple $2,135 $14,470
What is considered income for the affordable connectivity program?
You are likely eligible if your households income is below 200% of the Federal Poverty Line, or if you or someone you live with currently receives a government benefit like SNAP, Medicaid, SSI, WIC, Pell Grant, or Free and Reduced-Price Lunch.
What does Lis insurance cover?
Extra Help (also called the low-income subsidy or LIS) is available to help people with Medicare who have limited income and resources pay for Medicare prescription drug coverage. Anyone who has Medicare can get Medicare Part D prescription drug coverage.
Who is eligible for the Limited income Net Program?
Program Eligibility Individuals must not be enrolled in any other Medicare Part D prescription drug plan; and must have either Medicare and Medicaid, or Medicare and the Low-Income Subsidy (LIS).
Related Searches
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Medicares LI NET Program was established on January 1, 2010, to provide temporary Part D prescription drug coverage for low-income Medicare beneficiaries not already in a Medicare drug plan.
Related links
University of New Mexico Student Health Plan Benefit Booklet
A state may offer premium subsidies through Medicaid or a state Child health plan (SCHIP) to low-income children and their families for qualified University-
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