Life is full of expenses. Your health insurance does not have to be one of them. Passport Advantage (HMO SNP) is designed to help you maintain an excellent quality of life.

What do Passport Advantage Members pay?

To be enrolled in Passport Advantage, you must have Medicare Parts A & B and full-dual Kentucky Medicaid coverage. Members that meet these requirements have full LIS (Low Income Subsidy) coverage.

Passport Advantage does not have plan premium and depending on your Medicaid eligibility, you may have $0 or low cost sharing amount for your medications. See chart below.

LIS (Low Income Subsidy) Summary Chart:


Passport LogoGeneric Drugs
(including drugs treated as generic)
All Other Drugs
LIS Level 3$0$0
LIS Level 2$1.30$3.90
LIS Level 1$3.60$8.95

2020 Benefits Chart

This information is not a complete description of benefits. Contact the plan for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums, and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. This premium is covered as long as you remain a full-dual Kentucky Medicaid enrollee.


Last Modified: January 1, 2020