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Low Income Subsidy
Summary Table
2008 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% Federal Poverty Level |
$0
|
$1.05 generic, $3.10 brand
|
$0
|
| Full-Benefit Dual Eligible > 100% Federal Poverty Level; Medicare Saving Program Participant (QMB-only, SLMB-only, or QI); Supplemental Security Income (but not Medicaid) Recipient; Application < 135% Federal Poverty Level with resources ≤ $7,790 ($12,440 if married)** |
$0
|
$2.25 generic, $5.60 brand
|
$0
|
| Applicant > 150% Federal Poverty Level with resources between $7,790-$11,990 ($12,440-$23,970 is married)** |
$56
|
15%
|
$2.25 generic, $5.60 brand
|
| Institutionalized full benefit dual eligible |
$0
|
$0
|
$0
|
| *Out-of-Pocket Threshold is $4,050 for 2008 |
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Comments:
Limited resources qualifying for "FULL" extra help: Beneficiaries with very low savings and income below 135% of the federal poverty level.
Limited resources qualifying for "PARTIAL" extra help: beneficiaries with limited savings and income below 150% of the federal poverty level.
Extra help has special income rules, based on but not identical to the rules for supplemental security income (SSI) Program; the rules for counting resources are for the most part the same as the standard SSI resource rules. The MAIN difference is that most liquid resources will NOT be counted when determining eligibility for extra help. The liquid resources that will be counted are those that can readily be converted to cash within 20 days such as checking and savings accounts. (Non-home real property is an example of not subject to the 20 day rule.)
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