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2019 Federal Poverty Level Guidelines (FPL): 2019/2020 LIS Qualifications and Benefits

Category: Medicaid, LIS, & Extra Help
Published on 2019-02-01 19:30:02


The 2019 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 ($16,862 if you are single or $22,829 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 2019, even if your income or assets no longer meet the requirements later in the year.

2019 Federal Poverty Level (FPL) Guideline Tables

  • 48 States and the District of Columbia
    2019 Federal Poverty Level (FPL) Guideline Table
    Family Size 100% 135% 140% 145% 150%
    1 $12,490.00 $16,861.50 $17,486.00 $18,110.50 $18,735.00
    2 $16,910.00 $22,828.50 $23,674.00 $24,519.50 $25,365.00
    3 $21,330.00 $28,795.50 $29,862.00 $30,928.50 $31,995.00
    4 $25,750.00 $34,762.50 $36,050.00 $37,337.50 $38,625.00
    5 $30,170.00 $40,729.50 $42,238.00 $43,746.50 $45,255.00
    6 $34,590.00 $46,696.50 $48,426.00 $50,155.50 $51,885.00
    7 $39,010.00 $52,663.50 $54,614.00 $56,564.50 $58,515.00
    8 $43,430.00 $58,630.50 $60,802.00 $62,973.50 $65,145.00
    9 $47,850.00 $64,597.50 $66,990.00 $69,382.50 $71,775.00
    10 $52,270.00 $70,564.50 $73,178.00 $75,791.50 $78,405.00
    Additional $4,420.00 $5,967.00 $6,188.00 $6,409.00 $6,630.00
    2019 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $9,230 (individuals) or < $14,600 (couples)*
    See resource and income level premium benefits in the charts below.

    For more information and to learn more about:



  • Alaska
    2019 Federal Poverty Level (FPL) Guidelines Table
    Family Size 100% 135% 140% 145% 150%
    1 $15,600.00 $21,060.00 $21,840.00 $22,620.00 $23,400.00
    2 $21,130.00 $28,525.50 $29,582.00 $30,638.50 $31,695.00
    3 $26,660.00 $35,991.00 $37,324.00 $38,657.00 $39,990.00
    4 $32,190.00 $43,456.50 $45,066.00 $46,675.50 $48,285.00
    5 $37,720.00 $50,922.00 $52,808.00 $54,694.00 $56,580.00
    6 $43,250.00 $58,387.50 $60,550.00 $62,712.50 $64,875.00
    7 $48,780.00 $65,853.00 $68,292.00 $70,731.00 $73,170.00
    8 $54,310.00 $73,318.50 $76,034.00 $78,749.50 $81,465.00
    Additional $5,530.00 $7,465.50 $7,742.00 $8,018.50 $8,295.00
    2019 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $9,230 (individuals) or < $14,600 (couples)*
    See resource and income level premium benefits in the charts below.


  • Hawaii
    2019 Federal Poverty Level (FPL) Guidelines Table
    Family Size 100% 135% 140% 145% 150%
    1 $14,380.00 $19,413.00 $20,132.00 $20,851.00 $21,570.00
    2 $19,460.00 $26,271.00 $27,244.00 $28,217.00 $29,190.00
    3 $24,540.00 $33,129.00 $34,356.00 $35,583.00 $36,810.00
    4 $29,620.00 $39,987.00 $41,468.00 $42,949.00 $44,430.00
    5 $34,700.00 $46,845.00 $48,580.00 $50,315.00 $52,050.00
    6 $39,780.00 $53,703.00 $55,692.00 $57,681.00 $59,670.00
    7 $44,860.00 $60,561.00 $62,804.00 $65,047.00 $67,290.00
    8 $49,940.00 $67,419.00 $69,916.00 $72,413.00 $74,910.00
    Additional $5,080.00 $6,858.00 $7,112.00 $7,366.00 $7,620.00
    2019 Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources < $9,230 (individuals) or < $14,600 (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, 2019 for the remainder of contract year 2019 and contract year 2020.  See 2019 figures in charts below.

Learn more about:
  • The Extra-Help program.
  • The resource limits and co-payment benefits for the full Low-Income Subsidy:  2019 & 2020, and
  • The resource limits and benefits for the partial Low-Income Subsidy:  2019 & 2020

2019 Premium Subsidy Resource/Income Limits for Individuals

Individual’s Countable Resources* Individual’s Countable Income Amount of the Premium Subsidy
$7,730 or less At or below 135% FPL 100%
$7,730.01 to $12,890 At or below 135% FPL 100% but less help with co-pays or deductibles
$12,890 or less More than 135% of FPL,
but at or below 140%
75%
$12,890 or less More than 140% of FPL,
but at or below 145%
50%
$12,890 or less More than 145% of FPL,
but less than 150%
25%
$12,890.01 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.

2019 Premium Subsidy Resource/Income Limits for Married Couples

Couple’s Countable
Resources*
Couple’s Countable Income Amount of the Premium Subsidy
$11,600 or less At or below 135% FPL 100%
$11,600.01 to $25,720 At or below 135% FPL 100% but less help with co-pays or deductibles
$25,720 or less More than 135% of FPL,
but at or below 140%
75%
$25,720 or less More than 140% of FPL,
but at or below 145%
50%
$25,720 or less More than 145% of FPL,
but less than 150%
25%
$25,720.01 or more Any amount Not eligible for premium subsidy

*
NOTE: If a couple expects to use some of their resources for funeral or burial expenses REDUCE the couple's countable resources by $3,000 before applying them to the chart limits. Meaning, you can take $3,000 off of your resources before determining your level of subsidy.

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

2020 LIS Copayment Benefits100% FPL    135% FPL     150% FPL
2019 LIS Copayment Benefits100% FPL    135% FPL     150% FPL
2018 LIS Copayment Benefits100% FPL    135% FPL     150% FPL
2017 LIS Copayment Benefits100% FPL    135% FPL     150% FPL
2016 LIS Copayment Benefits100% FPL    135% FPL     150% FPL
2015 LIS Copayment Benefits100% FPL    135% FPL     150% FPL
2014 LIS Copayment Benefits100% FPL    135% FPL     150% FPL
2013 LIS Copayment Benefits100% FPL    135% FPL     150% FPL






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