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Thursday, November 1, 2012

Limited Income Subsidy

By Jean Moore


The Centers for Medicare and Medicaid have a number of different programs that provide assistance to those who are currently unable to afford health care services or health treatment. One of these programs that is being used is called the limited income subsidy program. This program is a smaller part of the overall Medicare Part D plan which is used to assist individuals as well as families be able to pay for prescription drug coverage. The limited income subsidy program was started in 2005 and has been successful over the past seven years in helping families in need. However there are still critics who believe that there are many more improvements that can be made to the program.

In addition to helping cover the costs of prescription drugs, the limited income subsidy program also helps to cover extra costs associated with health insurance premiums as well as additional cost-sharing. Those who take advantage of the Medicare part D program are also commonly a part of other Medicare programs that help to lower health associated costs. In order to be eligible for limited income subsidy individuals and families must make below a certain income either as an individual or a couple. This number is changed in reference to the current economy as well as health care costs.

Beneficiaries of the limited income subsidy are required to make below 135% of the poverty level in order to receive full coverage for their monthly premium and annual deductible. Those who make over that amount may be eligible for partial coverage of both the monthly premium and the annual deductible. Through the use of the limited income subsidy, those who are enrolled will still have to pay a small amount in order to gain access to the necessary prescriptions. These payments are very reasonable and are only a fraction of the actual cost of the drugs, making the purchase possible for beneficiaries.

In order to be eligible for the program, an individual needs to have an income of less than $16,245 and resources that amount to less than $12,640. In the case that the individual is married, the combined income of the two must be less than $21,855 and the available resources less than $25,260. In order to determine these number many factors are taken into consideration including the cash within checking and savings accounts, retirement accounts, any stocks, bonds or mutual funds, life insurance policies, mortgages and properties that can be converted into cash under 20 days.

The other group of those enrolled has applied for and are now receiving coverage. Within the group of applicants for this program, more than 50% of the applications were denied, or chose not to participate in the program. In addition there is almost 20% of eligible individuals and families who do not take advantage of the program.




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