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2016 Federal Poverty Level Guidelines (FPL): 2016-2017 LIS Qualifications and Benefits

Category: Medicaid, LIS, & Extra Help
Published: Feb, 18 2016 09:02:46
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The 2016 Federal Poverty Level (FPL) Guidelines determine the income level requirements for people applying for the Medicare Part D Low Income Subsidy (LIS) program, also known as the "Extra Help" program.

If your income is below 135% of the FPL (or for the remainder of 2016: $16,038 if you are single or $21,627 for married couples), you could qualify for the full Low Income Subsidy (resource limits also apply - see charts below). 

Please notice that 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 or Extra Help may help pay your monthly Medicare Part D plan premiums and a portion of your formulary drug costs.

2016 Federal Poverty Level (FPL) Tables

  • 48 States and the District of Columbia
    2016 Federal Poverty Level (FPL) Table
    Family Size 100% 135% 140% 145% 150%
    1 $11,880.00 $16,038.00 $16,632.00 $17,226.00 $17,820.00
    2 $16,020.00 $21,627.00 $22,428.00 $23,229.00 $24,030.00
    3 $20,160.00 $27,216.00 $28,224.00 $29,232.00 $30,240.00
    4 $24,300.00 $32,805.00 $34,020.00 $35,235.00 $36,450.00
    5 $28,440.00 $38,394.00 $39,816.00 $41,238.00 $42,660.00
    6 $32,580.00 $43,983.00 $45,612.00 $47,241.00 $48,870.00
    7 $36,730.00 $49,585.50 $51,422.00 $53,258.50 $55,095.00
    8 $40,890.00 $55,201.50 $57,246.00 $59,290.50 $61,335.00
    9 $45,050.00 $60,817.50 $63,070.00 $65,322.50 $67,575.00
    10 $49,210.00 $66,433.50 $68,894.00 $71,354.50 $73,815.00
    For each
    additional
    Person, add    		 $4,160.00 $5,616.00 $5,824.00 $6,032.00 $6,240.00
    2016 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $7,280 (individuals) or < $10,930 (couples)* 
    See resource and income level premium benefits in the charts below.


    Learn more about:
    • the Extra-Help program.
    • resource limits and co-payment benefits for the full Low-Income Subsidy
      2016 & 2017, and the
    • resource limits and benefits for the partial Low-Income Subsidy
      2016 & 2017


  • Alaska
    2016 Federal Poverty Level (FPL) Table
    Family Size 100% 135% 140% 145% 150%
    1 $14,840.00 $20,034.00 $20,776.00 $21,518.00 $22,260.00
    2 $20,020.00 $27,027.00 $28,028.00 $29,029.00 $30,030.00
    3 $25,200.00 $34,020.00 $35,280.00 $36,540.00 $37,800.00
    4 $30,380.00 $41,013.00 $42,532.00 $44,051.00 $45,570.00
    5 $35,560.00 $48,006.00 $49,784.00 $51,562.00 $53,340.00
    6 $40,740.00 $54,999.00 $57,036.00 $59,073.00 $61,110.00
    7 $45,920.00 $61,992.00 $64,288.00 $66,584.00 $68,880.00
    8 $51,120.00 $69,012.00 $71,568.00 $74,124.00 $76,680.00
    9 $56,320.00 $76,032.00 $78,848.00 $81,664.00 $84,480.00
    10 $61,520.00 $83,052.00 $86,128.00 $89,204.00 $92,280.00
    For each
    additional
    Person, add    		 $5,200.00 $7,020.00 $7,280.00 $7,540.00 $7,800.00
    2016 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $7,280 (individuals) or < $10,930 (couples)* 
    See 2017 resource and income level premium benefits in the charts below.


  • Hawaii
    2016 Federal Poverty Level (FPL) Table
    Family Size 100% 135% 140% 145% 150%
    1 $13,670.00 $18,454.50 $19,138.00 $19,821.50 $20,505.00
    2 $18,430.00 $24,880.50 $25,802.00 $26,723.50 $27,645.00
    3 $23,190.00 $31,306.50 $32,466.00 $33,625.50 $34,785.00
    4 $27,950.00 $37,732.50 $39,130.00 $40,527.50 $41,925.00
    5 $32,710.00 $44,158.50 $45,794.00 $47,429.50 $49,065.00
    6 $37,470.00 $50,584.50 $52,458.00 $54,331.50 $56,205.00
    7 $42,230.00 $57,010.50 $59,122.00 $61,233.50 $63,345.00
    8 $47,010.00 $63,463.50 $65,814.00 $68,164.50 $70,515.00
    9 $51,790.00 $69,916.50 $72,506.00 $75,095.50 $77,685.00
    10 $56,570.00 $76,369.50 $79,198.00 $82,026.50 $84,855.00
    For each
    additional
    Person, add    		 $4,780.00 $6,453.00 $6,692.00 $6,931.00 $7,170.00
    2016 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $7,280 (individuals) or < $10,930 (couples)*
    See 2017 resource and income level premium benefits in the charts below.

* The actual amount of resources allowable may be updated in April, 2016 for the remainder of contract year 2016 and contract year 2017.  The April 2016 updated figures are ≤ $8,780 (individuals) or ≤ $13,930 (couples).  See 2017 figures in charts below.

Learn more about:
  • the Extra-Help program.
  • resource limits and co-payment benefits for the full Low-Income Subsidy
    2016 & 2017, and the
  • resource limits and benefits for the partial Low-Income Subsidy
    2016 & 2017

2017 Premium Subsidy Resource/Income Limits for Individuals

Individual’s Countable Resources Individual’s Countable Income Amount of the Premium Subsidy
$7,390 or less At or below 135% FPL 100%
$7,390.01 to $12,320 At or below 135% FPL 100% but less help with co-pays or deductibles
$12,320 or less More than 135% of FPL,
but at or below 140% 		75%
$12,320 or less More than 140% of FPL,
but at or below 145% 		50%
$12,320 or less More than 145% of FPL,
but less than 150% 		25%
$12,320.01 or more Any amount Not eligible for premium subsidy


2017 Premium Subsidy Resource/Income Limits for Married Couples

Couple’s Countable
Resources		 Couple’s Countable Income Amount of the Premium Subsidy
$11,090 or less At or below 135% FPL 100%
$11,090.01 to $24,600 At or below 135% FPL 100% but less help with co-pays or deductibles
$24,600 or less More than 135% of FPL,
but at or below 140% 		75%
$24,600 or less More than 140% of FPL,
but at or below 145% 		50%
$24,600 or less More than 145% of FPL,
but less than 150% 		25%
$24,600.01 or more Any amount Not eligible for premium subsidy

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

2019 LIS Copayment Benefits:  100% FPL    135% FPL     150% FPL
2018 LIS Copayment Benefits:  100% FPL    135% FPL     150% FPL
2017 LIS Copayment Benefits:  100% FPL    135% FPL     150% FPL
2016 LIS Copayment Benefits:  100% FPL    135% FPL     150% FPL
2015 LIS Copayment Benefits:  100% FPL    135% FPL     150% FPL
2014 LIS Copayment Benefits:  100% FPL    135% FPL     150% FPL
2013 LIS Copayment Benefits:  100% FPL    135% FPL     150% FPL


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