Sierra Health and Life
 
SHL Home
2014 LIS Premium Summary Chart

Sierra Spectrum monthly plan premium for people who get Extra Help from Medicare to help pay for their prescription drug costs

If you get Extra Help/Low-Income Subsidy (LIS) 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. The amount of Extra Help you get will determine your total monthly plan premium as a member of our plan.

This table shows you what your monthly plan premium will be if you get Extra Help.

Your level of Extra Help

Monthly premium for Sierra Spectrum*

100%

$15.10

75%

$16.30

50%

$17.50

25%

$18.80

*This does not include any Medicare Part B premium you may have to pay.

Sierra Spectrum 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 (1-800-633-4227). TTY users should 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 Customer Service 1-877-559-4512; TTY: 711. Customer Service hours: October 1 through February 14: 8 a.m. to 8 p.m. local time, 7 days a week. February 15 through September 30: 8 a.m. to 8 p.m. local time, Monday - Friday. On Saturday, Sunday and holidays, please leave a detailed message and a representative will return your call within a business day.

H2905_141029_121748 Pending
Last update: 10/14

??