The Centers for Medicare and Medicaid Services (CMS) released the 2020 low-income premium subsidy
amounts (or Benchmark premiums) for Medicare Part D plans on July 31, 2019, and in 2020, thirty-three (33) regions will
lower their Medicare Part D Low-Income Subsidy (LIS) benchmark values and only one (1) region will have a slight
increase their benchmark premium.
Here are a few state highlights of
the 2020 LIS benchmarks:
- Ohio
will see the largest benchmark decrease with a 2020 LIS subsidy of
$28.54
as compared to
$32.92 in 2019.
Colorado
had the largest benchmark decrease last year.
- Arkansas
will have the only benchmark increase with a 2020 LIS benchmark
of $24.96
as compared to
$24.81
in 2019.
Arkansas
also had the largest benchmark increase in 2019.
- Wisconsin
will continue to have the highest benchmark premium of all CMS PDP
regions at $39.91.
Last year,
Wisconsin
also had the highest benchmark premium at $40.80.
- Texas
will continue to have the lowest benchmark premium at
$20.78.
Texas
also had the lowest benchmark in 2019.
What is the LIS Benchmark Premium?
As a reminder, the benchmark premium is the maximum monthly Medicare Part D plan premium that will be paid by CMS for
persons qualifying for the low-income subsidy (LIS) or the Medicare Part D "
Extra Help"
program.
If a person receiving the
low-income subsidy
enrolls in a Medicare Part D plan that has a premium higher than the subsidy amount listed below for
their state, the beneficiary is responsible for paying the difference in premiums (unless the difference between the benchmark premium and the plan premium are relatively small, please see the
explanation of the de minimis premium policy below*).
Below is a chart showing how the annual Medicare Part D LIS Benchmark premiums have fluctuated since 2006. The example states were chosen due to their relatively large population of seniors.
You can click on the premium subsidy in the table below to see the stand-alone Medicare Part D prescription drug plans (PDPs) for the selected year that qualify for the
$0 LIS premium (the 2020 Medicare Part D plan information will be available starting October 1, 2019).
CMS
Region |
State(s) |
2020
Subsidy |
2019
Subsidy |
2018
Subsidy |
2017
Subsidy |
2016
Subsidy |
2015
Subsidy |
2014
Subsidy |
2013
Subsidy |
2012
Subsidy |
2011
Subsidy |
2010
Subsidy |
2009
Subsidy |
2008
Subsidy |
2007
Subsidy |
2006
Subsidy |
1 |
NH, ME |
$29.67 |
$33.20 |
$34.27 |
$32.99 |
$32.82 |
$29.60 |
$27.78 |
$33.49 |
$31.18 |
$28.90 |
$26.96 |
$28.12 |
$30.64 |
$30.72 |
$36.09 |
2 |
CT, MA, RI, VT |
$34.77 |
$36.20 |
$35.58 |
$34.83 |
$31.14 |
$29.65 |
$27.99 |
$31.35 |
$32.04 |
$33.66 |
$34.57 |
$31.74 |
$29.17 |
$27.35 |
$30.27 |
3 |
NY |
$36.55 |
$39.33 |
$38.98 |
$40.99 |
$39.73 |
$36.94 |
$37.23 |
$43.22 |
$39.79 |
$38.69 |
$33.32 |
$27.71 |
$24.18 |
$24.45 |
$29.83 |
4 |
NJ |
$35.48 |
$37.16 |
$35.97 |
$40.81 |
$39.98 |
$37.64 |
$37.10 |
$37.04 |
$36.00 |
$35.74 |
$35.01 |
$30.99 |
$31.23 |
$28.12 |
$31.37 |
5 |
DE, DC, MD |
$29.65 |
$29.98 |
$30.70 |
$33.22 |
$33.45 |
$30.61 |
$32.34 |
$34.96 |
$34.57 |
$34.28 |
$33.71 |
$30.85 |
$30.78 |
$29.65 |
$33.46 |
6 |
PA, WV |
$35.63 |
$37.03 |
$37.18 |
$39.45 |
$35.30 |
$33.91 |
$35.50 |
$36.57 |
$34.32 |
$34.07 |
$32.09 |
$29.23 |
$26.59 |
$28.45 |
$32.59 |
7 |
VA |
$27.88 |
$30.61 |
$30.05 |
$32.52 |
$32.78 |
$29.47 |
$29.34 |
$30.06 |
$30.95 |
$33.25 |
$34.15 |
$31.72 |
$31.03 |
$30.52 |
$34.42 |
8 |
NC |
$26.36 |
$28.91 |
$30.16 |
$31.37 |
$31.07 |
$29.34 |
$28.28 |
$32.04 |
$33.00 |
$34.87 |
$34.90 |
$33.45 |
$33.43 |
$32.13 |
$36.30 |
9 |
SC |
$23.78 |
$24.55 |
$23.03 |
$26.03 |
$26.57 |
$28.78 |
$33.87 |
$38.75 |
$36.15 |
$36.90 |
$35.02 |
$32.01 |
$31.12 |
$31.41 |
$34.88 |
10 |
GA |
$25.34 |
$25.68 |
$24.53 |
$26.43 |
$25.78 |
$26.47 |
$29.32 |
$34.22 |
$31.18 |
$32.83 |
$29.62 |
$29.16 |
$30.04 |
$31.07 |
$33.15 |
11 |
FL |
$28.47 |
$30.25 |
$29.07 |
$29.13 |
$28.07 |
$25.83 |
$22.13 |
$24.76 |
$23.82 |
$25.41 |
$27.45 |
$21.47 |
$19.16 |
$22.63 |
$29.07 |
12 |
AL, TN |
$28.69 |
$31.40 |
$30.62 |
$31.76 |
$31.32 |
$30.20 |
$29.67 |
$33.69 |
$31.71 |
$33.72 |
$30.73 |
$29.80 |
$28.29 |
$29.60 |
$32.33 |
13 |
MI |
$30.15 |
$32.91 |
$33.28 |
$34.17 |
$33.47 |
$31.46 |
$32.46 |
$34.18 |
$34.37 |
$34.71 |
$34.92 |
$32.08 |
$30.49 |
$30.79 |
$33.22 |
14 |
OH |
$28.54 |
$32.92 |
$31.95 |
$32.30 |
$29.52 |
$28.64 |
$28.93 |
$29.87 |
$29.41 |
$29.67 |
$30.47 |
$28.40 |
$26.82 |
$28.51 |
$30.69 |
15 |
IN, KY |
$29.52 |
$31.75 |
$31.24 |
$32.06 |
$31.90 |
$31.79 |
$34.95 |
$37.22 |
$35.92 |
$36.44 |
$35.75 |
$33.95 |
$33.50 |
$32.42 |
$35.69 |
16 |
WI |
$39.91 |
$40.80 |
$40.04 |
$40.09 |
$37.70 |
$35.32 |
$37.03 |
$38.25 |
$36.67 |
$36.96 |
$38.20 |
$38.15 |
$31.03 |
$29.67 |
$31.27 |
17 |
IL |
$26.04 |
$27.37 |
$27.50 |
$28.68 |
$29.60 |
$28.23 |
$28.59 |
$30.94 |
$30.23 |
$30.65 |
$31.59 |
$30.18 |
$30.26 |
$29.66 |
$31.60 |
18 |
MO |
$30.10 |
$32.06 |
$29.99 |
$30.07 |
$26.13 |
$28.28 |
$31.21 |
$34.59 |
$32.05 |
$34.92 |
$40.01 |
$31.89 |
$26.71 |
$27.88 |
$31.37 |
19 |
AR |
$24.96 |
$24.81 |
$22.56 |
$22.58 |
$20.92 |
$24.76 |
$30.03 |
$34.15 |
$31.62 |
$32.12 |
$28.48 |
$26.89 |
$27.69 |
$30.51 |
$35.45 |
20 |
MS |
$25.13 |
$26.85 |
$25.81 |
$26.53 |
$28.14 |
$29.33 |
$30.56 |
$34.56 |
$33.40 |
$33.01 |
$33.02 |
$31.53 |
$31.35 |
$31.70 |
$36.39 |
21 |
LA |
$32.21 |
$33.06 |
$30.92 |
$32.80 |
$32.13 |
$31.28 |
$31.75 |
$37.33 |
$35.01 |
$34.75 |
$31.32 |
$27.48 |
$24.62 |
$28.45 |
$34.14 |
22 |
TX |
$20.78 |
$23.96 |
$24.59 |
$27.34 |
$28.05 |
$27.31 |
$27.73 |
$31.83 |
$29.99 |
$30.48 |
$27.53 |
$25.36 |
$25.01 |
$26.93 |
$31.68 |
23 |
OK |
$28.74 |
$30.84 |
$29.65 |
$30.83 |
$30.72 |
$29.97 |
$30.18 |
$32.80 |
$31.53 |
$33.62 |
$32.31 |
$29.36 |
$28.04 |
$30.35 |
$35.13 |
24 |
KS |
$31.53 |
$32.46 |
$31.43 |
$30.27 |
$30.67 |
$30.32 |
$34.21 |
$36.04 |
$36.67 |
$36.94 |
$35.77 |
$33.66 |
$30.62 |
$30.56 |
$33.44 |
25 |
IA, MN, MT, ND, NE, SD, WY |
$35.37 |
$35.78 |
$33.99 |
$34.02 |
$30.93 |
$30.00 |
$32.23 |
$34.61 |
$36.02 |
$37.47 |
$37.55 |
$33.19 |
$30.61 |
$29.50 |
$33.11 |
26 |
NM |
$23.58 |
$26.61 |
$24.60 |
$22.84 |
$20.72 |
$21.19 |
$19.92 |
$22.54 |
$21.27 |
$22.62 |
$21.42 |
$20.55 |
$19.28 |
$22.72 |
$25.95 |
27 |
CO |
$31.26 |
$32.00 |
$34.18 |
$32.04 |
$29.89 |
$28.93 |
$26.90 |
$31.92 |
$32.38 |
$32.85 |
$30.99 |
$30.17 |
$24.59 |
$27.37 |
$28.92 |
28 |
AZ |
$32.09 |
$32.62 |
$32.88 |
$35.11 |
$33.17 |
$32.89 |
$27.49 |
$29.41 |
$26.84 |
$27.34 |
$24.75 |
$16.22 |
$15.92 |
$21.37 |
$24.62 |
29 |
NV |
$23.91 |
$25.33 |
$27.08 |
$27.09 |
$25.38 |
$24.25 |
$22.78 |
$20.35 |
$22.97 |
$30.06 |
$27.31 |
$20.20** |
$16.64 |
$20.56 |
$23.46 |
30 |
OR, WA |
$32.57 |
$33.80 |
$34.58 |
$34.83 |
$33.80 |
$33.81 |
$34.82 |
$37.46 |
$36.45 |
$35.30 |
$35.60 |
$31.76 |
$30.19 |
$28.71 |
$30.60 |
31 |
ID, UT |
$36.84 |
$38.66 |
$40.24 |
$39.66 |
$39.51 |
$39.74 |
$39.02 |
$42.15 |
$40.86 |
$40.68 |
$40.89 |
$37.46 |
$33.53 |
$31.77 |
$33.62 |
32 |
CA |
$32.01 |
$34.79 |
$35.51 |
$36.28 |
$31.05 |
$28.84 |
$28.10 |
$29.88 |
$30.86 |
$32.35 |
$28.99 |
$24.86 |
$19.80 |
$21.03 |
$23.25 |
33 |
HI |
$25.21 |
$25.73 |
$25.38 |
$26.52 |
$26.23 |
$27.91 |
$25.69 |
$33.33 |
$30.41 |
$29.76 |
$25.55 |
$25.01 |
$24.32 |
$26.35 |
$27.44 |
34 |
AK |
$31.36 |
$33.60 |
$32.92 |
$34.06 |
$36.36 |
$32.86 |
$37.07 |
$34.71 |
$36.46 |
$36.89 |
$38.00 |
$36.00 |
$36.42 |
$33.56 |
$34.66 |
Changes in the number of stand-alone Medicare Part D plans qualifying for the $0 LIS premium (2006-2019).
*Note: Under the CMS
de minimis premium policy, "Part D plans are required to charge full-premium subsidy
eligible beneficiaries a monthly Part D beneficiary premium equal to the applicable low-income premium
subsidy amount, if the plan’s beneficiary premium for basic prescription drug coverage exceeds
the low-income premium subsidy amount by $2 or less."
"Under the Affordable Care Act (ACA) §3303(a), a prescription drug plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD) may volunteer to waive the portion of the monthly adjusted basic beneficiary premium that is a
de minimis amount above the low-income subsidy (LIS) benchmark for a subsidy eligible individual. The law prohibits CMS from reassigning LIS members from plans who volunteered to waive the
de minimis amount. The
de minimis amount for 2020 will be $2. The
de minimis amount for 2020 for a plan participating in the Part D Payment Modernization Model will also be $2."
**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.