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"Best Available Evidence" for Medicare

Information Last Updated: 7/10/2018

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Best Available Evidence (BAE) Information on the Medicare Website

Medicare requires health plans to use the “Best Available Evidence” regarding a member’s eligibility to receive a Low Income Subsidy (LIS) at a specific level. The Low Income Subsidy enables the member to pay less at the pharmacy. Sometimes Medicare does not have the most current information so they ask health plans to collect evidence from a member proving the member qualifies.

Medicare has a link on its website to policies and information available about Best Available Evidence/BAE. Medicare will continue to update this page as additional materials are issued.

https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/Best_Available_Evidence_Policy.html