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2021 Federal Poverty Level Guidelines (FPL): 2021 LIS Qualifications and Benefits

Category: Medicaid, LIS, & Extra Help
Published: Jan 15, 2021 06:34:03


The 2021 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.

Remember:  The Medicare Part D Extra-Help or Low-Income Subsidy program helps pay both your monthly Medicare prescription drug plan premiums and Medicare Part D drug costs.  People who qualify for Medicaid automatically qualify for Medicare Part D Extra Help.

Qualifying for full-LIS benefits:

If your income is below 135% of the FPL ($17,388 if you are single or $23,517 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 LIS benefits for residents of Alaska and Hawaii -- please see the charts below.


Qualifying for Partial-LIS benefits:

Even if you do not qualify for full-LIS benefits, you might be eligible for partial-LIS benefits if your income level is at or below 150% FPL (resource limits also apply - see charts below).


Applying for the Medicare Part D Extra Help program:

To apply for Extra Help go to: https://secure.ssa.gov/i1020/start. You could receive Extra Help for the remainder of 2021, even if your income or assets no longer meet the requirements later in the year.

2021 Federal Poverty Level (FPL) Guideline Tables

  • 48 States and the District of Columbia
    2021 Federal Poverty Level (FPL) Guideline Table
    Family Size 100% 135% 140% 145% 150%
    1$12,880$17,388$18,032$18,676$19,320
    2$17,420$23,517$24,388$25,259$26,130
    3$21,960$29,646$30,744$31,842$32,940
    4$26,500$35,775$37,100$38,425$39,750
    5$31,040$41,904$43,456$45,008$46,560
    6$35,580$48,033$49,812$51,591$53,370
    7$40,120$54,162$56,168$58,174$60,180
    8$44,660$60,291$62,524$64,757$66,990
    9$49,200$66,420$68,880$71,340$73,800
    10$53,740$72,549$75,236$77,923$80,610
    Additional$4,540$6,129$6,356$6,583$6,810
    2021 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources*  < $9,470 (individuals) or < $14,960 (couples)
    See resource and income level premium benefits in the charts below.

    For more information and to learn more about:



  • Alaska
    2021 Federal Poverty Level (FPL) Guidelines Table
    Family Size 100% 135% 140% 145% 150%
    1 $16,090 $21,722 $22,526 $23,331 $24,135
    2 $21,770 $29,390 $30,478 $31,567 $32,655
    3 $27,450 $37,058 $38,430 $39,803 $41,175
    4 $33,130 $44,726 $46,382 $48,039 $49,695
    5 $38,810 $52,394 $54,334 $56,275 $58,215
    6 $44,490 $60,062 $62,286 $64,511 $66,735
    7 $50,170 $67,730 $70,238 $72,747 $75,255
    8 $55,850 $75,398 $78,190 $80,983 $83,775
    Additional $5,680 $7,668 $7,952 $8,236 $8,520
    2021 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources* < $9,470 (individuals) or < $14,960 (couples)
    See resource and income level premium benefits in the charts below.


  • Hawaii
    2021 Federal Poverty Level (FPL) Guidelines Table
    Family Size 100% 135% 140% 145% 150%
    1 $14,820 $20,007 $20,748 $21,489 $22,230
    2 $20,040 $27,054 $28,056 $29,058 $30,060
    3 $25,260 $34,101 $35,364 $36,627 $37,890
    4 $30,480 $41,148 $42,672 $44,196 $45,720
    5 $35,700 $48,195 $49,980 $51,765 $53,550
    6 $40,920 $55,242 $57,288 $59,334 $61,380
    7 $46,140 $62,289 $64,596 $66,903 $69,210
    8 $51,360 $69,336 $71,904 $74,472 $77,040
    Additional $5,220 $7,047 $7,308 $7,569 $7,830
    2021 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources* < $9,470 (individuals) or < $14,960 (couples)
    See resource and income level premium benefits in the charts below.
*This amount includes the $1,500 per person burial allowance. The resources allowable may be updated in April, 2021 for the remainder of contract year 2021 and contract year 2022.

Learn more about:
  • The Extra-Help program.
  • The resource limits and co-payment benefits for the full Low-Income Subsidy:  2021 | 2022, and
  • The resource limits and benefits for the partial Low-Income Subsidy:   2021 | 2022
Note on Resource limits: CMS (Medicare) adds the burial allowance to the resource limit. So, the resource limits in the tables above have been increased by $1,500 per person.  Social Security does not include the burial allowance to their resources tables and states that you should reduce your resources by $1,500 per person.


2021 Premium Subsidy Resource/Income Limits for Individuals

Individual’s Countable Resources* Individual’s Countable Income Amount of the Premium Subsidy
$7,970 or less At or below 135% FPL 100%
$7,970.01 to $13,290 At or below 135% FPL 100% but less help with co-pays or deductibles
$13,290 or less More than 135% of FPL,
but at or below 140%
75%
$13,290 or less More than 140% of FPL,
but at or below 145%
50%
$13,290 or less More than 145% of FPL,
but less than 150%
25%
$13,290.01 or more Any amount Not eligible for premium subsidy

*NOTE: If an individual expects to use some of his or her resources for funeral or burial expenses, REDUCE the individual's countable resources by $1,500 before applying them to the chart limits.  Meaning, you can take $1,500 off of your resources before determining your level of subsidy.

2021 Premium Subsidy Resource/Income Limits for Married Couples

Couple’s Countable
Resources*
Couple’s Countable Income Amount of the Premium Subsidy
$11,960 or less At or below 135% FPL 100%
$11,960.01 to $26,520 At or below 135% FPL 100% but less help with co-pays or deductibles
$26,520 or less More than 135% of FPL,
but at or below 140%
75%
$26,520 or less More than 140% of FPL,
but at or below 145%
50%
$26,520 or less More than 145% of FPL,
but less than 150%
25%
$26,520.01 or more Any amount Not eligible for premium subsidy











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