Resource Limits for the Medicare Part D Low-Income Subsidy:
Annual Adjustment for 2007
To apply and qualify for the Part D low-income subsidy, Medicare beneficiaries must have resources no greater than the resource limits established by the Medicare Modernization Act (MMA). When determining whether a beneficiary qualifies for the Medicare Part D low income subsidy, $1,500 per person in resources are excluded from consideration if the beneficiary indicates that they expect to use some of their resources for burial expenses. Therefore, these resource limits are increased by $1,500 per person if the beneficiary expects to use some of their resources for burial expenses.
Table of Resource Limits Used to Determine Eligibility for Low-Income Subsidy (LIS)
| LIS Level | Marital Status | 2006 LIS Resource Limit* | 2007 LIS Resource Limit* |
|---|---|---|---|
| Full Subsidy LIS | Single | $7,500 | $7,620 |
| Married | $12,000 | $12,190 | |
| All Other LIS | Single | $11,500 | $11,710 |
| Married | $23,000 | $23,410 |
*These resource limits include $1,500 per person for burial expenses.
Low-Income Subsidy Eligible Beneficiary Cost-sharing
2007 Maximum LIS Beneficiary Cost-Sharing Table
| Low-income Subsidy Category | Deductible | Copayment up to Out-of-Pocket Threshold | Copayment above Out-of-pocket Threshold |
|---|---|---|---|
| Institutionalized Full-Benefit Dual Eligible | $0 | $0 | $0 |
| Full-Benefit Dual Eligible ≤ 100% FPL | $0 | $1 generic, $3.10 brand | $0 |
| Full-Benefit Dual Eligible > 100% FPL; Medicare Saving Program Participant (QMB-only, SLMB-only, or QI); Supplemental Security Income (but not Medicaid) Recipient; Applicant < 135% FPL with resources ≤ $7,620 ($12,190 if married)** |
$0 | $2.15 generic, $5.35 brand | $0 |
| Applicant < 150% FPL with resources bet. $7,620-$11,710 ($12,190-$23,410 if married)** | $53 | 15% | $2.15 generic, $5.35 brand |
| *Out-of-Pocket Threshold is $3,850 for 2007. ** Resource limits displayed include $1,500 per person for burial expenses. |
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