Jan Neal Law Firm LLC

Alabama Elder and Special Needs Law

2016 MSP and LIS and LIS Cost Sharing

2016 MEDICARE SAVINGS PROGRAM (MSP)

 

ALLOWABLE INCOME
BENEFIT SINGLE MONTHLY INCOME (OR MARRIED LIVING APART) MARRIED MONTHLY INCOME
QMB 1010.00 1355.00
SLMB 1208.00 1622.00
QI-1 1357.00 1823.00
QDWI 4045.00 5425.00
ALLOWABLE RESOURCES:

THERE IS NO RESOURCE LIMIT IN ALABAMA

 

2016 LOW INCOME SUBSIDY (EXTRA HELP)

 

 

ALLOWABLE RESOURCES
FU LL SUBSIDY (100 – 135%) PARTIAL SUBSIDY (140 – 150%)
Single $ 7,280 Single $12,140
Married $10,930 Married $24,250

 

 

 

 

ALLOWABLE INCOME
FAMILY SIZE PERCENT OF POVERTY GUIDELINE

 

100%               135%              1400/o              145%               150%

1 1010.00 1356.50 1406.00 1455.50 1505.00
2 1356.67 1824.50 1891.33 1958.17 2025.00
3 1703.34 2292.50 2376.66 2460.84 2545.00
4 2050.01 2760.50 2861.99 2963.51 3065.00
5 2396.68 3228.50 3347.32 3466.18 3585.00
6 2743.35 3696.50 3832.65 3968.85 4105.00
7 3090.02 4164.50 4317.98 4471.52 4625.00
8 3436.69 4632.50 4803.31 4974.19 5145.00
Each Additional Person  

+346.67

 

+468.00

 

+485.33

 

+502.67

 

+520.00

 

2016 Maximum LISBeneficiary Cost-Sharing Table

 

 

 

Low-income Subsidy Category

 

 

Deductible

Copayment up to Out-of-Pocket Threshold* Copayment above Out-of-pocket Threshold*
lnstitutionatized Full-Benefit Dual Eligible; or

Beneficiaries Receiving Home and Community- Based Services

$0 $0 $0
Full-Benefit Dual Eligible            100% FPL $0 $1.20 generic,

$3.60 brand

$0
Full-Benefit Dual Eligible > I OOOA, FPL; or

Medicare Saving Program Participant (QMB-only, SLMB-only, or QI); or

Supplemental Security Income (but not Medicaid) Recipient; or

Applicant < 135% FPL with resources       $8,780 ($13,930 if married)**

$0 $2.95 generic,

$7.40 brand

$0
Applicant < 150% FPL with resources between

$8,780 – $13,640 ($13,930 – $27,250 if married)**

$74 15% $2.95 generic,

$7.40 brand

*Out-of-Pocket Threshold is $4,850 for 2016.

** Resource limits displayed include $1,500 per person for burial expenses.