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Prospective & Enrolled Members: 800-405-9681 (TTY 711) | Provider Inquiries: 1-855-969-5907 (TTY 711)

Some people with limited resources and income also may be able to get “Extra Help” to pay for the costs of a Medicare prescription drug plan, including monthly premiums, annual deductibles and prescription co-payments.

  • Have full Medicaid coverage
  • Have Supplemental Security Income (SSI) or
  • Participate in a state program that pays your Medicare premiums
A home-aid showing a man paperwork
  • Request help to obtain evidence of your proper copay level, or
  • If you already have the evidence, to provide this evidence to us.

As a Part D plan sponsor, CMS regulations require us to have a process to help you determine if you are eligible for the Low Income Subsidy (LIS) when some of your documentation is missing or there is a conflict between the CMS system and your actual status.

Before you enroll, Provider Partners Health Plans will tell you what your plan premium will be with a low-income subsidy.

  • Documentation from the facility showing Medicaid payments for a full calendar month
  • Documentation from the state that confirms Medicaid payment to the facility for a full calendar month
  • A screen print from State Medicaid showing the institutional status based on a full calendar month stay for Medicaid payment purposed
  • A copy of valid State Medicaid Card showing eligibility dates
  • Complete documentation of contact with State Medicaid verifying the Medicaid status (including date and time of contact, name, title, and phone number of the person contacted)
  • Documentation that confirms active Medicaid status
  • A printout from the State electronic enrollment file showing Medicaid status
  • A screen print from the State’s Medicaid systems showing Medicaid status
  • Other documentation provided by the State showing Medicaid status

Provider Partners Health Plans
PO Box 21063
Eagan, MN 55121

2024 Monthly Plan Premium for People who get Extra Help from Medicare to Help Pay for their Prescription Drug Costs

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare.

If you get extra help, your monthly plan premium will be $0 for any of the plan(s) below. (This does not include any Medicare Part B premium you may have to pay.)

  • Provider Partners Illinois Advantage Plan
  • Provider Partners Maryland Advantage Plan
  • Provider Partners Missouri Advantage Plan
  • Provider Partners North Carolina Advantage Plan
  • Provider Partners Pennsylvania Advantage Plan
  • Provider Partners Texas Advantage Plan
  • Provider Partners Maryland Community Plan
  • Provider Partners Missouri Community
  • Provider Partners North Carolina Community Plan
  • Provider Partners Pennsylvania Community Plan

Provider Partners Health Plans premium includes coverage for both medical services and prescription drug coverage. If you aren’t getting extra help, you can see if you qualify by calling:

  • 1-800-Medicare or TTY users call 1-877-486-2048 (24 hours a day/7 days a week),
  • Your State Medicaid Office, or
  • The Social Security Administration at 1-800-772-1213. TTY users should call 1-800- 325-0778 between 7 a.m. and 7 p.m., Monday through Friday.

If you have any questions, please call Member Service at 1-800-405-9681. TTY/TDD users should call 711 from 8:00 A.M. to 8:00 P.M., seven days a week from October 1 through March 31; 8:00 A.M. to 8:00 P.M. Monday to Friday from April 1 through September 30.

Page Last Updated: 9/7/2023

Provider Partner Health Plans are HMO-SNPs with Medicare contracts. Enrollment in Provider Partner Health Plans depends on contract renewal. Y0135_PPHPWEB_2024