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2013 Federal Poverty Level Guidelines: 2013-2014 LIS Qualifications and Benefits

Published on 2013-04-27 15:09:56Category: Medicaid, LIS and Extra Help

The 2013 Federal Poverty Level (FPL) Guidelines determine the income level requirements for people applying for the Low Income Subsidy (LIS) program. For the remainder of 2013, if your income is below 135% of the FPL ($15,511.50 if you are single or $20,938.50 for married couples), you could qualify for the full Low Income Subsidy (resource limits also apply - see charts below). Beginning in 2014, the full LIS income level will be raised to 138% of the FPL ($15,856.20 if you are single or $21,403.80 for married couples). Different income levels apply to residents of Alaska and Hawaii -- see charts below. Even if you don’t qualify for full LIS benefits, you could be eligible for partial LIS benefits if your income level is at or below 150% FPL (resource limits also apply - see charts below). Remember, the LIS subsidy helps to pay both your monthly plan premiums and drug costs.

Full Low-Income Subsidy Income Requirements (100% of FPL)
Persons
in Family
48 Contiguous
States & D.C.
Alaska Hawaii
1 $11,490 $14,350 $13,230
2 $15,510 $19,380 $17,850
3 $19,530 $24,410 $22,470
4 $23,550 $29,440 $27,090
5 $27,570 $34,470 $31,710
6 $31,590 $39,500 $36,330
7 $35,610 $44,530 $40,950
8 $39,630 $49,560 $45,570
For each additional
Person, add
$4,020 $5,030 $4,620
Federal Register 78 FR 5182 (Thursday, January 24, 2013), pp. 5182 -5183
Resource Limits for Full-LIS

 
 
Full Low-Income Subsidy Income Requirements (135% of FPL)
Persons
in Family
48 Contiguous
States & D.C.
Alaska Hawaii
1 $15,511.50 $19,372.50 $17,860.50
2 $20,938.50 $26,163.00 $24,097.50
3 $26,365.50 $32,953.50 $30,334.50
4 $31,792.50 $39,744.00 $36,571.50
5 $37,219.50 $46,534.50 $42,808.50
6 $42,646.50 $53,325.00 $49,045.50
7 $48,073.50 $60,115.50 $55,282.50
8 $53,500.50 $66,906.00 $61,519.50
2013 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL
and resources < $8,580 (individuals) or < $13,620 (couples)*** 
See resource and income level premium benefits in the charts below.

 
 
Partial Low-Income Subsidy Income Requirements (138% of FPL)*
Persons
in Family
48 Contiguous
States & D.C.
Alaska Hawaii
1 $15,856.20 $19,803.00 $18,257.40
2 $21,403.80 $26,744.40 $24,633.00
3 $26,951.40 $33,685.80 $31,008.60
4 $32,499.00 $40,627.20 $37,384.20
5 $38,046.60 $47,568.60 $43,759.80
6 $43,594.20 $54,510.00 $50,135.40
7 $49,141.80 $61,451.40 $56,511.00
8 $54,689.40 $68,392.80 $62,886.60
*Beginning in 2014, Eligibility for QMB/SLMB/QI, SSI or applied and income at or below 138% FPL rather than income at or below 135% FPL
and resources < $8,580 (individuals) or < $13,620 (couples)*** 
See resource and income level premium benefits in the charts below.

 
 
Partial Low-Income Subsidy Income Requirements (150% of FPL)
Persons
in Family
48 Contiguous
States & D.C.
Alaska Hawaii
1 $17,235 $21,525 $19,845
2 $23,265 $29,070 $26,775
3 $29,295 $36,615 $33,705
4 $35,325 $44,160 $40,635
5 $41,355 $51,705 $47,565
6 $47,385 $59,250 $54,495
7 $53,415 $66,795 $61,425
8 $59,445 $74,340 $68,355
Applied and income below 150% FPL
and resources between $8,581-$13,300 (individuals) or $13,621-$26,580 (couples)***
(category code 4). 
See resource and income level premium benefits in the charts below.

*** The actual amount of resources allowable may be updated for contract year 2014.

2013 Premium Subsidy Resource/Income Limits for Individuals

Individual’s Countable Resources

Individual’s Countable Income

Amount of the Premium Subsidy

$7,080 or less

At or below 135% FPL

100%

$7,080.01 to $11,800

At or below 135% FPL

100% but less help with co-pays or deductibles

$11,800 or less

More than 135% of FPL, but at or below 140%

75%

$11,800 or less

More than 140% of FPL but at or below 145%

50%

$11,800 or less

More than 145% of FPL but less than 150%

25%

$11,800.01 or more

Any amount

Not eligible for subsidy

2013 Premium Subsidy Resource/Income Limits for Married Couples

Couple’s Countable Resources

Couple’s Countable Income

Amount of the Premium Subsidy

$10,620 or less

At or below 135% FPL

100%

$10,620.01 to $23,580

At or below 135% FPL

100% but less help with co-pays or deductibles

$23,580 or less

More than 135% of FPL, but at or below 140%

75%

$23,580 or less

More than 140% of FPL, but at or below 145%

50%

$23,580 or less

More than 145% of FPL but less than 150%

25%

$23,580.01 or more

Any amount

Not eligible for subsidy


 

To review co-payments for both Full- and Partial-LIS, select the link below:

2013 LIS Copayment Benefits100% FPL    135% FPL     150% FPL  
2014 LIS Copayment Benefits100% FPL    135% FPL     150% FPL

 
 


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