HI 03030.025:
Resource Limits for Subsidy Eligibility
Effective Dates: 05/18/2017 - Present- Effective Dates: 12/20/2017 - Present
- TN 13 (12-11)
- HI 03030.025 Resource Limits for Subsidy Eligibility
- Citations:
- Soc. Sec. Act, §1860D-14(a)(3)(D)
- A. Background for resource limits for subsidy eligibility
- To be eligible for a subsidy, an individual or couple must have countable resources below certain limits prescribed by law that adjust annually based on changes in the consumer price index.
- NOTE: If an individual or couple expects to use some of his or her resources for funeral or burial expenses DON’T COUNT $1500 per individual ($3000 for a married couple); the HIGHER resource level applies.
B. Policy for 2017 resource limits for subsidy eligibility- B. Policy for 2018 resource limits for subsidy eligibility
- 1. Individual
The two resource limits for an individual in 2017 are $7,390 and $12,320.- The two resource limits for an individual in 2018 are $7,560 and $12,600.
a. Countable resources are $12,320 or more- a. Countable resources are $12,600 or more
If countable resources are $12,320.01 or more, the individual is not eligible for any subsidy but can enroll in Part D.- If countable resources are $12,600.01 or more, the individual is not eligible for any subsidy but can enroll in Part D.
b. Countable resources are $7,390 or less- b. Countable resources are $7,560 or less
If countable resources are $7,390 or less, the individual can be eligible for a subsidy depending on the amount of countable income.- If countable resources are $7,560 or less, the individual can be eligible for a subsidy depending on the amount of countable income.
c. Countable resources are greater than $7,390 but do not exceed $12,320- c. Countable resources are greater than $7,560 but do not exceed $12,600
If countable resources are $7,390.01 or more but do not exceed $12,320, the individual can be eligible for a subsidy depending on countable income.- If countable resources are $7,560.01 or more but do not exceed $12,600, the individual can be eligible for a subsidy depending on countable income.
- If his or her income is less than 135% of the Federal Poverty Level (FPL), he or she:
- * receives a 100% premium subsidy; and
* is eligible for less help with co-pays and deductibles than an individual with $7,390 or less in countable resources, as explained in HI 03001.005.- * is eligible for less help with co-pays and deductibles than an individual with $7,560 or less in countable resources, as explained in HI 03001.005.
d. Table: 2017 resource limits for individuals- d. Table:2018 resource limits for individuals
- Individual’s Countable Resources
- Individual’s Countable Income
- Amount of the Premium Subsidy
$7,390 or less- $7,560 or less
- At or below 135% FPL
- 100%
$7,390.01 to $12,320- $7,560.01 to $12,600
- At or below 135% FPL
- 100% but less help with co-pays or deductibles
$12,320 or less- $12,600 or less
- More than 135% of FPL, but at or below 140%
- 75%
$12,320 or less- $12,600 or less
- More than 140% of FPL but at or below 145%
- 50%
$12,320 or less- $12,600 or less
- More than 145% of FPL but less than 150%
- 25%
$12,320.01 or more- $12,600.01 or more
- Any amount
- Not eligible for subsidy
- 2. Married couple
The two resource limits for a married couple in 2017 are $11,090 and $24,600. The couple resource limits apply to a married couple who live together whether one or both members apply for the subsidy.- The two resource limits for a married couple in 2018 are $11,340 and $25,150. The couple resource limits apply to a married couple who live together whether one or both members apply for the subsidy.
a. Countable resources are $24,600.01 or more- a. Countable resources are $25,150.01 or more
If countable resources are $24,600.01 or more, the couple is not eligible for any subsidy regardless of countable income, but can enroll in Part D.- If countable resources are $25,150.01 or more, the couple is not eligible for any subsidy regardless of countable income, but can enroll in Part D.
b. Countable resources are $11,090 or less- b. Countable resources are $11,340 or less
If countable resources are $11,090 or less, the couple can be eligible for a subsidy depending on the amount of countable income.- If countable resources are $11,340 or less, the couple can be eligible for a subsidy depending on the amount of countable income.
c. Countable resources are greater than $11,090 but do not exceed $24,600- c. Countable resources are greater than $11,340 but do not exceed $25,150
If countable resources are $11,090.01 or more but do not exceed $24,600, the couple can be eligible for a subsidy depending on countable income.- If countable resources are $11,340.01 or more but do not exceed $25,150, the couple can be eligible for a subsidy depending on countable income.
- If their income is less than 135% FPL, the couple:
- * receives a 100% premium subsidy; and
* is eligible for less help with co-pays and deductibles than the couple who has $11,090 or less in countable resources, as explained in HI 03001.005G.- * is eligible for less help with co-pays and deductibles than the couple who has $11,340 or less in countable resources, as explained in HI 03001.005G.
d. Table: 2017 resource limits for married couples- d. Table: 2018 resource limits for married couples
- Couple’s Countable Resources
- Couple’s Countable Income
- Amount of the Premium Subsidy
$11,090 or less- $11,340 or less
- At or below 135% FPL
- 100%
$11,090.01 to $24,600- $11,340.01 to $25,150
- At or below 135% FPL
- 100% but less help with co-pays or deductibles
$24,600 or less- $25,150 or less
- More than 135% of FPL, but at or below 140%
- 75%
$24,600 or less- $25,150 or less
- More than 140% of FPL, but at or below 145%
- 50%
$24,600 or less- $25,150 or less
- More than 145% of FPL but less than 150%
- 25%
$24,600.01 or more- $25,150.01 or more
- Any amount
- Not eligible for subsidy
C. Policy for 2015 and 2016 resource limits for subsidy eligibility- C. Policy for 2017 resource limits for subsidy eligibility
- 1. Individual
- The resource limits for an individual in 2017 are $7,390 and $12,320.
- 2. Married couple
- The resource limits for a married couple in 2017 are $11,090 and $24,600.
- D. Policy for 2015 and 2016 resource limits for subsidy eligibility
- 1. Individual
- The resource limits for an individual in 2015 and 2016 are $7,280 and $12,140.
- 2. Married couple
- The resource limits for a married couple in 2015 and 2016 are $10,930 and $24,250.
D. Policy for 2014 resource limits for subsidy eligibility- E. Policy for 2014 resource limits for subsidy eligibility
- 1. Individual
- The resource limits for an individual in 2014 are $7,160 and $11,940.
- 2. Married couple
- The resource limits for a married couple in 2014 are $10,750 and $23,860.
E. Policy for 2013 resource limits for subsidy eligibility- F. Policy for 2013 resource limits for subsidy eligibility
- 1. Individual
- The resource limits for an individual in 2013 are $7,080 and $11,800.
- 2. Married couple
- The resource limits for a married couple in 2013 are $10,620 and $23,580.
F. Policy for 2012 resource limits for subsidy eligibility- G. Policy for 2012 resource limits for subsidy eligibility
- 1. Individual
- The resource limits for an individual in 2012 are $6,940 and $11,570.
- 2. Married couple
- The resource limits for a married couple in 2012 are $10,410 and $23,120.
G. Policy for 2011 resource limits for subsidy eligibility- H. Policy for 2011 resource limits for subsidy eligibility
- 1. Individual
- The resource limits for an individual in 2011 are $6,680 and $11,140.
- 2. Married couple
- The resource limits for a married couple in 2011 are $10,020 and $22,260.
H. Policy for 2009 and 2010 resource limits for subsidy eligibility- I. Policy for 2009 and 2010 resource limits for subsidy eligibility
- 1. Individual
- The resource limits for an individual in 2009 and 2010 are $6,600 and $11,010.
- 2. Married couple
- The resource limits for a married couple in 2009 and 2010 are $9,910 and $22,010.
I. Policy for 2008 resource limits for subsidy eligibility- J. Policy for 2008 resource limits for subsidy eligibility
- 1. Individual
- The resource limits for an individual in 2008 are $6,290 and $10,490.
- 2. Married couple
- The resource limits for a married couple in 2008 are $9,440 and $20,970.
J. Policy for 2007 resource limits for subsidy eligibility- K. Policy for 2007 resource limits for subsidy eligibility
- 1. Individual
- The resource limits for an individual in 2007 are $6,120 and $10,210.
- 2. Married couple
- The resource limits for a married couple in 2007 are $9,190 and $20,410.
K. Policy for 2006 resource limits for subsidy eligibility- L. Policy for 2006 resource limits for subsidy eligibility
- 1. Individual
- The resource limits for an individual in 2006 are $6,000 and $10,000.
- 2. Married couple
- The resource limits for a married couple in 2006 are $9,000 and $20,000.
L. References- M. References
- * HI 03001.005 Medicare Part D Extra Help (Low-Income Subsidy or LIS)
- * HI 03020.055 Income Limits for Subsidy Eligibility
- * DHHS Poverty Guidelines and Federal Register References
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