eligible for QDWI, assuming he meets all the nonfinancial requirements of the state’s Medicaid program. As this example demonstrates, an individual can have a substantial amount of earned income and use QDWI. Low Income Subsidy (Extra Help)- Financial Assistance Program #2 As explained in the first part of this unit, there are a number of Part D out-of-pocket expenses, which vary based on the private prescription drug plan the beneficiary chooses. For many beneficiaries, these costs are unaffordable. When Congress created Part D, it also created a financial assistance program to help low-income beneficiaries pay for the Part D out- of-pocket expenses. The formal name for this financial assistance program is Low Income Subsidy, but it’s also called “Extra Help.” LIS isn’t a state program, which is often a point of confusion. LIS is a program administered by CMS. The LIS program provides two levels of help: Full Low Income Subsidy and Partial Low Income Subsidy. To be eligible for LIS, some groups must have income below certain FPLs, which are published in the Federal Register each year by the Department of Health and Human Services (DHHS). The poverty levels are the same regardless of the age of the family members. One set of poverty levels applies to the 48 contiguous states and the District of Columbia, with Alaska and Hawaii having separate and slightly higher poverty levels. When an individual applies for LIS, Social Security will apply the FPL that corresponds to the individual’s state of residence in the month that the individual applied. Remember: Example FPLs provided in this unit are based on the 48 contiguous states and on the 2016 (not the 2017) FPLs. This manual is printed prior to the release of the new FPLs, which generally occurs in late January or, February. As a result, the 2016 FPLs are used throughout this unit. In addition to some groups having income limits, some groups must have resources below the current year’s resource limit. If a beneficiary indicates he or she would use some or all of his or her resources for
eligible for QDWI, assuming he meets all the nonfinancial requirements of the state’s Medicaid program. As this example demonstrates, an individual can have a substantial amount of earned income and use QDWI. Low Income Subsidy (Extra Help)- Financial Assistance Program #2 As explained in the first part of this unit, there are a number of Part D out-of-pocket expenses, which vary based on the private prescription drug plan the beneficiary chooses. For many beneficiaries, these costs are unaffordable. When Congress created Part D, it also created a financial assistance program to help low-income beneficiaries pay for the Part D out- of-pocket expenses. The formal name for this financial assistance program is Low Income Subsidy, but it’s also called “Extra Help.” LIS isn’t a state program, which is often a point of confusion. LIS is a program administered by CMS. The LIS program provides two levels of help: Full Low Income Subsidy and Partial Low Income Subsidy. To be eligible for LIS, some groups must have income below certain FPLs, which are published in the Federal Register each year by the Department of Health and Human Services (DHHS). The poverty levels are the same regardless of the age of the family members. One set of poverty levels applies to the 48 contiguous states and the District of Columbia, with Alaska and Hawaii having separate and slightly higher poverty levels. When an individual applies for LIS, Social Security will apply the FPL that corresponds to the individual’s state of residence in the month that the individual applied. Remember: Example FPLs provided in this unit are based on the 48 contiguous states and on the 2016 (not the 2017) FPLs. This manual is printed prior to the release of the new FPLs, which generally occurs in late January or, February. As a result, the 2016 FPLs are used throughout this unit. In addition to some groups having income limits, some groups must have resources below the current year’s resource limit. If a beneficiary indicates he or she would use some or all of his or her resources for
2017_WIPA_Manual_Module_4_S.docx