The Limited Income Newly Eligible Transition (LI NET) Program provides immediate, temporary drug coverage if you qualify for Medicare Part D, Medicare's low-income subsidy also known as Extra Help, and you have no prescription drug coverage. You can get this benefit for up to 2 months until you choose and enroll in a Medicare drug plan.

Who qualifies for LI NET?

You qualify for the LI NET program if you:

  • Have been found eligible for Medicare Part D Extra Help, including if you are a:
    • Full-benefit dual-eligible beneficiary: You have Medicare and full Medicaid benefits.
    • SSI-only beneficiary: You have Medicare and get Supplemental Security Income (SSI) but do not have Medicaid.
    • Partial-benefit, dual-eligible beneficiary: You have Medicare and qualify for Medicare Savings Programs (MSPs) but not full Medicaid.
    • Extra Help applicant: You have applied for Extra Help through Social Security and got a Notice of Award letter.
  • Have no other drug coverage, such as Part D or Retiree Drug Subsidy (RDS) plan
  • Did not opt out of (request not to have) auto-enrollment
  • Are not enrolled in a Part C (Medicare Advantage) plan
  • Have a permanent address in the 50 states or Washington, DC

How do I enroll in LI NET?

If you have Medicare and full Medicaid benefits, you are automatically enrolled in LI NET. You will get a letter from CMS saying you qualify for Extra Help and have opted into LI NET.

If you are a partial-dual beneficiary or you applied directly for Extra Help, you must enroll in LI NET at the pharmacy. You must provide one of the following documents to pharmacy staff to get immediate prescription fills and LI NET enrollment:

  • A letter from Social Security or CMS showing you have been awarded Extra Help (such as an official award letter or notice of change)
  • A copy of your current state Medicaid award letter with effective dates
  • State eligibility verification system queries (interactive voice response, online)

Which drugs does LI NET cover? Are there restrictions?

LI NET includes all drugs covered under Medicare Part D. It does not cover drugs excluded from Part D. There are limits on some drugs for safety reasons, including quantity limits or prior authorization. All other medications are limited to a 60-day supply under LI NET.

Is LI NET retroactive (does it take effect on a prior date)?

If full Medicaid or SSI eligibility is retroactive, then LI NET is retroactive. If you have retroactive coverage, you may be able to get reimbursed (refunded) for covered Part D prescriptions you paid for, at any pharmacy, during any past months in which you qualified for retroactive coverage. You must show a notice or award letter within 90 days of the date on the notice or letter.

Not all LI NET is retroactive. If you get a notice from CMS saying you have been automatically enrolled in a Part D plan, you cannot get retroactive coverage.

Can I be reimbursed for out-of-pocket costs while enrolled in LI NET?

If you paid out-of-pocket costs for medications while enrolled in LI NET, you may qualify for reimbursement. You have 36 months from the date the prescription was filled to ask for reimbursement.

Can I be reimbursed for out-of-pocket expenses paid before I enrolled in LI NET?

If you paid out-of-pocket costs for medications before your LI NET coverage kicked in, you may be able to get reimbursement. You must meet the following guidelines on the date the prescription was filled:

  • Eligible for Medicare Part D
  • No other prescription drug coverage (Medicare Part D, RDS)
  • Not enrolled in a Medicare Advantage Plan (Part C)
  • Have not opted out of Medicare’s auto-enrollment
  • Permanent address in the 50 states or Washington, DC
  • Full dual-eligible

How long can I keep LI NET?

Enrollment in LI NET is temporary, usually for 1 to 2 months. This gives you time to choose a Medicare Part D prescription drug plan that fits your needs. If you don’t choose a plan during this time, Medicare will automatically enroll you into what they call a "benchmark plan".

You can compare Part D plans using the Medicare Plan Finder. This is the best way to find a drug plan that covers your current medications and fits your budget.