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| 2012 Low-Income Subsidy Premium Amounts (includes 2011 - 2006 for comparison)
Publish On 2011-08-04 , 11:34 AM
The Centers for Medicare and Medicaid Services (CMS) has released the 2012 low-income premium subsidy amounts (or Benchmark) for Medicare Part D plans. This is the maximum monthly premium that will be paid by CMS for persons qualifying for "Extra Help." If a person receiving the low-income subsidy (LIS) enrolls in a Medicare Part D plan which has a premium higher than the amount listed below for their state, the beneficiary is responsible for paying the difference in premium.
Click on the 2012 premium to see 2012 plans qualifying for the $0 premium.
| Region |
State(s) |
2012
Subsidy |
2011
Subsidy |
2010
Subsidy |
2009
Subsidy |
2008
Subsidy |
2007
Subsidy |
2006
Subsidy |
| 1 |
NH, ME |
$31.18 |
$28.90 |
$26.96 |
$28.12 |
$30.64 |
$30.72 |
$36.09 |
| 2 |
CT, MA, RI, VT |
$32.04 |
$33.66 |
$34.57 |
$31.74 |
$29.17 |
$27.35 |
$30.27 |
| 3 |
NY |
$39.79 |
$38.69 |
$33.32 |
$27.71 |
$24.18 |
$24.45 |
$29.83 |
| 4 |
NJ |
$36.00 |
$35.74 |
$35.01 |
$30.99 |
$31.23 |
$28.12 |
$31.37 |
| 5 |
DE, DC, MD |
$34.57 |
$34.28 |
$33.71 |
$30.85 |
$30.78 |
$29.65 |
$33.46 |
| 6 |
PA, WV |
$34.32 |
$34.07 |
$32.09 |
$29.23 |
$26.59 |
$28.45 |
$32.59 |
| 7 |
VA |
$30.95 |
$33.25 |
$34.15 |
$31.72 |
$31.03 |
$30.52 |
$34.42 |
| 8 |
NC |
$33.00 |
$34.87 |
$34.90 |
$33.45 |
$33.43 |
$32.13 |
$36.30 |
| 9 |
SC |
$36.15 |
$36.90 |
$35.02 |
$32.01 |
$31.12 |
$31.41 |
$34.88 |
| 10 |
GA |
$31.18 |
$32.83 |
$29.62 |
$29.16 |
$30.04 |
$31.07 |
$33.15 |
| 11 |
FL |
$23.82 |
$25.41 |
$27.45 |
$21.47 |
$19.16 |
$22.63 |
$29.07 |
| 12 |
AL, TN |
$31.71 |
$33.72 |
$30.73 |
$29.80 |
$28.29 |
$29.60 |
$32.33 |
| 13 |
MI |
$34.37 |
$34.71 |
$34.92 |
$32.08 |
$30.49 |
$30.79 |
$33.22 |
| 14 |
OH |
$29.41 |
$29.67 |
$30.47 |
$28.40 |
$26.82 |
$28.51 |
$30.69 |
| 15 |
IN, KY |
$35.92 |
$36.44 |
$35.75 |
$33.95 |
$33.50 |
$32.42 |
$35.69 |
| 16 |
WI |
$36.67 |
$36.96 |
$38.20 |
$38.15 |
$31.03 |
$29.67 |
$31.27 |
| 17 |
IL |
$30.23 |
$30.65 |
$31.59 |
$30.18 |
$30.26 |
$29.66 |
$31.60 |
| 18 |
MO |
$32.05 |
$34.92 |
$40.01 |
$31.89 |
$26.71 |
$27.88 |
$31.37 |
| 19 |
AR |
$31.62 |
$32.12 |
$28.48 |
$26.89 |
$27.69 |
$30.51 |
$35.45 |
| 20 |
MS |
$33.40 |
$33.01 |
$33.02 |
$31.53 |
$31.35 |
$31.70 |
$36.39 |
| 21 |
LA |
$35.01 |
$34.75 |
$31.32 |
$27.48 |
$24.62 |
$28.45 |
$34.14 |
| 22 |
TX |
$29.99 |
$30.48 |
$27.53 |
$25.36 |
$25.01 |
$26.93 |
$31.68 |
| 23 |
OK |
$31.53 |
$33.62 |
$32.31 |
$29.36 |
$28.04 |
$30.35 |
$35.13 |
| 24 |
KS |
$36.67 |
$36.94 |
$35.77 |
$33.66 |
$30.62 |
$30.56 |
$33.44 |
| 25 |
IA, MN, MT, ND, NE, SD, WY |
$36.02 |
$37.47 |
$37.55 |
$33.19 |
$30.61 |
$29.50 |
$33.11 |
| 26 |
NM |
$21.27 |
$22.62 |
$21.42 |
$20.55 |
$19.28 |
$22.72 |
$25.95 |
| 27 |
CO |
$32.38 |
$32.85 |
$30.99 |
$30.17 |
$24.59 |
$27.37 |
$28.92 |
| 28 |
AZ |
$26.84 |
$27.34 |
$24.75 |
$16.22 |
$15.92 |
$21.37 |
$24.62 |
| 29 |
NV |
$22.97 |
$30.06 |
$27.31 |
$20.20* |
$16.64 |
$20.56 |
$23.46 |
| 30 |
OR, WA |
$36.45 |
$35.30 |
$35.60 |
$31.76 |
$30.19 |
$28.71 |
$30.60 |
| 31 |
ID, UT |
$40.86 |
$40.68 |
$40.89 |
$37.46 |
$33.53 |
$31.77 |
$33.62 |
| 32 |
CA |
$30.86 |
$32.35 |
$28.99 |
$24.86 |
$19.80 |
$21.03 |
$23.25 |
| 33 |
HI |
$30.41 |
$29.76 |
$25.55 |
$25.01 |
$24.32 |
$26.35 |
$27.44 |
| 34 |
AK |
$36.46 |
$36.89 |
$38.00 |
$36.00 |
$36.42 |
$33.56 |
$34.66 |
*Note: The 2009 low-income benchmark premium amount calculated for region 29 is $19.68. The low-income premium subsidy amount of $20.20 is the lowest monthly beneficiary premium for a PDP that offers basic coverage in region 29. Section 1860D-14(b)(3) of the Social Security Act states that the low-income premium subsidy amount is the greater of the lowest monthly beneficiary premium for a PDP that offers basic coverage and the low-income benchmark premium amount.
| |
| | Comment
| | 1. | We found that there are many legit foreign pharmacies that provide for safe and reliable medications at much lower prices. The idea that only US pharmacies can provide quality medications like vicodin, hydrocodone, norco, lorcet is obviously shallow. Foreign internet pharmacies will also often offer their patients a free online consultation. It would not be hard for authorities to recommend the use of such pharmacies to patients in need, but instead the DEA insist that the consumers’ safety is at stake when ordering at foreign pharmacies, since the safety can be compromised due to falsification and adulteration of the pharmaceutical products available in other countries is indicated findrxonline in article on pharmacies online.
- by Sam Worthington, 2010-03-10, 1:55 AM
| | 2. | Well,the New Year has come and already things are a mess! I spent four days,the past two weeks, on the phone with Social Security,Medicare,Medicaid,and my Advantage Plan Provider.Calls were made again and again to all of these offices and each and every time I was given a different answer.I am Low Income Subsidy.All of 2009 my premium was paid by the State.The State paid $26 monthly and I paid $2 monthly. Social Security told me not to pay my bill I received for my Advantage Plan.They told me that I was approved for another year for "extra help".I had to pay $28 or else loose my Advantage Plan along with my prescription coverage.
I called my Advantage Plan Provider one last time this morning.I was told that for 2009 my Part C was 10 cents.Now my Part C jumped to $28 for 2010. The State paid my Premium for meds which was $26 and then I paid $2 for all of 2009.Well,I was told that my Advantage Plan Provider did not submit the Part D Proposal to Medicare.They submitted Part C.My Provider said the State will not pay Part C as that is for the Doctor and Hospital.My co-pay has gone up from $1.10 to $2.50, I think,for generic meds.Name brand jumped from $3.10 to $6.50.WHERE IS MY SUBSIDY FOR EXTRA HELP??????? What the heck is the State paying? Nothing anymore for meds? But I am LIS and approved for another year of "EXTRA HELP".There isn't any extra help as they claim.The State is helping by keeping the cost of my co-pays down?They went up.The State cut the Help out!!!
I would also like to know why Part C was only 10 cents last year and has jumped to $28 now.The State was paying the Premium for Part D.I don't see the State paying anything on Part D. The Provider submitted only Part C to the State.What goes with that? None of this makes any sense to me.
One last thing,why am I paying $28 for Part C which I was told is Doctor and Hospital.The State is giving me "extra help" paying my medicare premium.I thought that is for the Doctor and Hospital.Why is the Insurance getting a premium for Doctor and Hospital?Why was it only 10 cents all year for me and jumps to $28 for 2010?
I am not the only one that doesn't understand all of this.A lot of Senior Citizens are calling their Insurance Companies.Things are switched around with Part C and Part D and Senior Citizens are now seeing a tremendous jump in a Premium for Part C ----10 cents to $28 .
What is this Government and President doing to the Seniors???????? Call your Reps, Senior Citizens. But remember Obama said that he was going to make it better for us. We should be enjoying the last few years of our lives. We paid our "dues". No, we are going to have to cut back on food and or meds. Why doesn't the President cut back and everyone else in Washington follow "suit"? I see the President on TV, I turn him off.
- by Nancy, 2010-01-05, 3:52 AM
| | 3. | Its down right crazy that the formula used to determine if you qualify for the Low Income Subsidy (LIS)is DIFFERENT from the formula used to calculate our SSA raise. They use a different formula. The INCOME LIMIT is based on the FPL Federal Poverty Level / guidelines however there is no adjustment for a small or large raise in SSA check. Thats crazy. Maybe there are only a few that lost their subsidy but it is a life and death matter for me. My drugs totaled %59,000 last year. My copay was about $,2000. Now that the 5.8 precent raise placed me over the LIS limit my copays are projected to be over $6,500. I dont see how I can do it with 14,688 income (I think the LIS mimit was $14,250. I dont call that a raise. Someone needs to wake up and realize there has to be a special figure used to calculate and adjust for raises. In simple terms if we get a $100 raise per yea the LIS figur should raise $100 But it is not .
I saw some post asking what or how to get LIS help. I might be off a few dollars but if you not in Alaska or Hawaii I beleave if your income (before they take out for part B and D etc) is below $16,245 then you qualify for LIS (again I might be off some) LIS has different help based on your income. I think the .FPL is near @1,080.00 If you SSA is 150% of that amount you get some help, 134% more help and major help if you get equal or less than the FPL that I think is 1,080. But be careful some ins co's will allow you zero premium if you get LIS others do not but all of them have to give you a substantial discount at the register if you are approved for the LIS. You can apply on the net, do so a soon as possible. I think the asset limit is $11,500 and they no longer need to know if your going to use your assets for burial exxpensis. but there is something about life insurance policy face value. Check it out, it will not hurt to apply. Also remember your state welfare program (Medicaid in Fl) will help you if your medical bills (paid or unpaid) offset your income enough to allow you to qalify for Medicaid in Januarary then somehow CMS provides the LIS regardless if your bills are not high in Feb or March.
I wish I could be more helpfull but a person should not be penalized because he or she gets a raise in SSA when their under a SSA program. (Part D)
Good luck
- by Bug, 2009-11-26, 4:18 AM
| | 4. | Does any one know what the income limits for drug assistance will be for 2010? Social Security checks will not be going up in 2010 or 2011. We missed assistance in 2009 by $511.00. The limit in 2009 went up $855.00 so what about 2010? It is very hard for us as just one drug is $1000.00 a month. We go into the doughnut hole very quickly. We need help!
- by E. Harlow, 2009-11-06, 9:22 PM
| | 5. | Massachusetts Prescription Advantage
- by Mary Boyd, 2009-10-29, 5:19 PM
| | 6. | how do you quilify for LIS in OK? jim
- by jim hendrix, 2009-10-01, 7:31 PM
| | 7. | I also lost my Low Income Subsidy (LIS) worth a lot to me. My RX total was $59,000 last year.
Aparently they use two different formulas to determine our raise (5.8% for SSA check) and the limit for LIS.
I was worried anyway becasue I was barely under the limit (without the $20 general exclusion I dont think I would have qualified last year.
They say LIS is worth about $4,000/yr but the Medicare.gov site says my co-pay will be over $6,800 next year. In my case I think it helped more.
There is help for some of us that LOST our LIS. Medicaide (aka by other names in other states) has a program called :"Share of Cost" or Cost of Share"
You might say " I know I dont qualify for medicaid" Right maybe not traditional. Im going to try to explain in laymens terms.
Lets say Medicaid says you cant make no more than $1,000/month to qualify for Medicaid and lets say you make 1,200 a month from SSA. If you save every single bill that has to do with copays and doctors/hospital bills, for example lets say your doctors bills (THEY DON'T HAVE TO BE PAID JUST OWED) Total about 250.00 then Medicaid will see that you income was 1200 less 250 for doctor bills and qualify your for the Share of Cost.
Here is the good part. Once you qualify for Medicaids Share of Cost or Cost of Share you notify Medicare.
In turn Medicare will instate you in the LOW INCOME SUBSIDY "FOR THE RESTS OF THE YEAR" Even if you no longer qualify for the Share of Cost for Feb or March it makes no difference. Once Medicare gives you LIS based on my poor example its good the rest of the year (As long as you dont hit the lottery or other income changes).
Just what we sick people need. Running back and forth from one office to the other running red tape just to get what was already ours until the 5.8% raise.
Why the LIS formula and the Medicare raises dont utilize the same formukla is beyond me. I dont know if it is to late but I thought Obama had a desire to eliminate the doughnut hole? If he fails eslewhere I wonder if its to late this year for him to eliminate the gap?
I hope this tidbit of info helps someone like me that lost their LIS. If I didnt have a credit card (and it may be taken away since they are tightening credit card requirements) I couldnt afford the $6,500 Copays.
2 medications are 750 ea that without them I will die.
If I never worked a day in my life and was on Medicaid I would be fully covered with my immune disease, plus Id have a nursing home to go to towards the end. If I loose my credit card Ill loose my drugs and Medicare aint going to give me a nursing home bed to die in. I hate to say it I woud have been better off if I had chosen to be a bumb.
Why did I listen to my parents and get aa good job?
PS I will press enter again I assume validation code was wrong for Im poresented with my post again
3rd
- by Coley, 2009-08-27, 8:30 PM
| | 8. | Angry about Medicare Part D that does not help the middle class? You can do something about it.
I have a plan to fix the prescription drug benefit and more.
Get people to Send a free prewritten fax to Sen. Minority leader Mitch McConnell telling him to STOP EVERY REPUBLICAN FILIBUSTER, get the Employee Free Choice act enacted into law, along with single payer universal health care, a fix for the Medicare Prescription drug benefit, a 10 dollar an hour minimum wage, an end to the Iraq war and until that happens you will boycott some Republican campaign contributors.
We have to hit the friends of the GOP in their wallets. Oh and if you only send your fax, this will fail. You need to get friends to send the fax and have their friends send the free fax and so on.
Thank you!
PS the prewritten fax reads thusly:
Hello
I want the following actions taken and legislation enacted into law.
Congress and the President must enact HR 676 single payer universal health care and set up a new prescription drug benefit in Medicare Part B covering 80% of the cost of all drugs with no extra monthly premiums, no extra yearly deductible, no means tests, no coverage gaps, and remove the means test for Medicare Part B and until that happens, I won't buy ANYTHING from Republican contributor Rite Aid Pharmacies.
The President must end the war in Iraq and until that happens I will not buy any products from Republican contributor and War contractor General Electric Corporation.
Congress and the President must enact a $10/HR MINIMUM WAGE into law and until this happens I will not go to any Republican contributor Wendy's Restaurants.
In 2008 Brown-Forman of Kentucky, the maker of Jack Daniels Whiskey and Southern Comfort gave Mitch McConnell money for his campaign.
SENATOR McCONNELL MUST NOT EXECUTE ANY REPUBLICAN FILIBUSTERS FOR 8 YEARS DURING THE OBAMA PRESIDENCY AND MUST GET THE EMPLOYEE FREE CHOICE ACT ENACTED INTO LAW AND UNTIL THAT HAPPENS I WON'T BUY JACK DANIELS WHISKEY OR SOUTHERN COMFORT OR ANY OTHER OF THEIR PRODUCTS.
Thank you.
- by www.democratz.org, 2009-04-02, 11:41 AM
| | 9. | Do Medigap policies follow the same rules as Medicare for covering off-label cancer drugs?
- by Yolande Kersey, 2009-03-27, 8:37 PM
| | 10. | I just found out my parents CPA told them they will never be able to enroll in Medicare! they have a tight budget now days and have had to take care of both of my grandparents while raising 2 daughters, giving money to people who asked, own land... using their savings to help when needed... and because they made too much and paid all those taxes there is no reward! what a fat slap in the face and ahuge stab in the back for being good hard working people! They will have to sell all the land they work their butts off for! why?
a friend of mine who's father was adead beat, never had a real job, gambled, lived on peoples sofas... etc etc... he qualifies but not my parents? what has this country come to? We give to those who constantly take advantage rather then those who actually support the economy? Well why don't I just becom a mooch? it's seems they get more then those who work? MAD, yes I'm mad, i'm angry that I get neck pains from sitting at a computer, backaches from younger harder worker days, sleepless nights from day to day work stress, getting up at 4am... I get nothing fromt he country I pay taxes to and support? Democraps, stop taking my money and giving to loosers! Quote me on that! -Crystal Peña
- by Crystal, 2009-03-21, 11:57 AM
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