Low-income subsidy premium summary table

This table shows you what your monthly plan premium will be if you get extra help from Medicare to help pay for your Medicare prescription drug plan costs.

Your level of extra help     What you'll pay for a monthly premium
100% $0
75% $0
50% $0
25% $0

To check your extra help status or level or to see if you qualify for extra help, call:

  • 1-800-MEDICARE (1-800-633-4227). TTY users call 1-877-486-2048 (24 hours a day/seven days a week)
  • Massachusetts MassHealth office: 1-800-841-2900 (TTY: 1-800-497-4648)
  • Social Security Administration: 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users call 1-800-325-0778.
  • Prescription Advantage: 1-800-AGE-INFO (1-800-243-4636), TTY: 1-877-610-0241

For information about the Centers for Medicare & Medicaid Services (CMS) Best Available Evidence (BAE) policy, visit the CMS website. (This link takes you away from the NaviCare website.)


Fallon Health is an HMO plan with a Medicare contract and a contract with the Massachusetts Medicaid program. Enrollment in Fallon Health depends on contract renewal. NaviCare is a voluntary program in association with MassHealth/EOHHS and CMS. NaviCare SCO is available to anyone age 65 and older who has MassHealth Standard and lives in the service area. Individuals who also have Medicare Parts A and B may enroll in NaviCare HMO SNP. You must continue to pay your Medicare Part B premium unless the Commonwealth of Massachusetts pays this premium for you. The NaviCare HMO SNP premium includes coverage for both medical services and prescription drug coverage.


H9001_N_2018_10 Approved 10192017
The information on this page was last updated on 10/1/2017.