Check premium assistance rates for your Medicare plan

What to do if you are not getting the correct amount of premium assistance

If your prescription copay is higher than you expected it to be, your pharmacist can send Priority Health proof that you have a low income right away so Priority Health can correct the government's records and you can get your prescription filled for the lower copay. We are required to accept any one of the following forms of evidence to help establish your subsidy level. These documents can be provided by you or by your pharmacist, advocate, representative, or family member.

  • A copy of your Medicaid card that includes your name and an eligibility date after June of last year; or
  • A copy of a state document that confirms you are eligible for Medicaid dated after June last year; or
  • A printout from the State electronic enrollment file showing your Medicaid status dated after June of last year; or
  • A screen print from the State’s Medicaid systems computer showing Medicaid status during a month after June of the previous calendar year, or
  • Other documentation provided by the State showing you were covered by Medicaid during a month after June of last year, or
  • For individuals who are not deemed eligible, but who apply and are found LIS eligible, a copy of the SSA award letter

For more information, see the policies on the Best Available Evidence at the Centers for Medicare and Medicaid Services website.