LI NET Medicare gives temporary drug coverage to people from low income households who haven’t yet enrolled in a Part D. It covers all drugs that Part D covers, allowing you to visit any pharmacy.

Medicare launched the Limited Income Newly Eligible Transition (LI NET) Program in 2010 to provide temporary Part D prescription drug coverage for beneficiaries from low-income households who have yet to join a Medicare drug plan.

In 2024, LI NET became a permanent part of the Medicare Part D program due to Section 118 of the Consolidated Appropriations Act of 2021. Humana currently administers the LI NET program nationwide.

Unlike Original Medicare (parts A and B), which is a government-run insurance plan, private insurers operate Medicare Part D drug plans. There are many different Part D plans, and depending on the plan you select, your exact benefits and costs will vary.

However, if you live on a lower income and are eligible for Medicare but haven’t yet enrolled in a Part D plan, you can qualify for the LI NET program under certain criteria. LI NET coverage lasts up to 2 months, giving you time to choose and sign up for a Part D plan that fits your needs.

Once you qualify, your enrollment in LI NET begins on the first day of the month when you become eligible and continues for 2 months. Some people may be eligible for retroactive coverage. If this applies to you, you can get reimbursed for any qualifying prescriptions from when you became eligible for LI NET or 36 days before you signed up for Part D coverage, whichever comes later.

Depending on how you qualify for LI NET, your exact coverage may vary slightly as follows:

  • You’re dually enrolled in full-benefit Medicare and Medicaid: 36 months of retroactive coverage.
  • You’re eligible for Supplemental Security Income (SSI): 36 months of retroactive coverage.
  • You’re eligible for Extra Help: 30 days of retroactive pharmacy counter coverage.
  • You’re eligible for certain Medicare Savings Programs (MSPs): 30 days of retroactive pharmacy counter coverage.

Pharmacy counter coverage means that when you pick up your medication, you will automatically pay reduced pricing according to your plan.

Each full Part D plan typically covers specific medications, determined by the plan’s formulary. However, LI NET maintains an open formulary, which means this program covers all medications that Part D plans can cover. Exceptions include those that Part D never covers or those that federal law prohibits.

However, you might need to provide proof of a particular diagnosis to secure coverage for certain medications under LI NET.

This program does not restrict network pharmacies, which means you can visit any pharmacy you want.

You don’t have a monthly premium or a deductible with LI NET. However, you may have a copay when you purchase prescription drugs. However, this will depend on how you’re eligible and your eligibility level.

In order for your pharmacy to bill LI NET, the pharmacist may be able to find this within the Medicare system. Alternatively, you may need to show the pharmacist your Medicaid card or another document that verifies either your Medicaid eligibility or your eligibility for Extra Help. Once they have a reasonable expectation of your eligibility, the pharmacy will generally bill your medications directly to the LI NET program.

For information about Medicare’s LI NET Program, call the LI NET help desk at 1-800-783-1307 between 8 a.m. and 11 p.m. Eastern Time (ET). TTY users should call 711.

Medicare Part D provides prescription drug coverage through private insurance companies, with costs varying depending on the plan you choose. The LI NET Program, started in 2010 and made a permanent option in 2024, can offer you temporary Part D coverage if you’re living on a low income and haven’t yet joined a full Part D plan.

With LI NET, you can get immediate drug coverage for up to two months, allowing you time to select and enroll in your preferred Part D plan. Humana manages the LI NET program, which features an open formulary and allows you to use any pharmacy without restrictions.