Billy and Norma are married and living together, and live in Kansas. Billy is age
70, receives Title II benefits of $1,308 and a private pension of $545 per month.
On November 24, 2023, Billy enrolls in Part D Medicare and applies for the premium
subsidy. Norma is not old enough for Medicare and is still working. Norma expects
annual gross earnings of $14,011. Assume their resources are within the limits for
eligibility.
Income Type

Income Calculation

Billy’s Social Security

$15,696 (12 x $1,308)

Billy’s Pension

+$6,540
(12 x $545)


$22,236


 $240 (12 x the $20 exclusion)


Countable Unearned Income = $21,996

Income Type

Income Calculation

Norma’s Wages

$14,011


$780 (12 x the $65 exclusion)


$13,231


$13,231 X .5 = $6,615.50 (onehalf exclusion)


Countable Earned Income $6,615.50


Countable Unearned Income +
$21,996


Total Countable Income = $28,611.50

Assume that the FPL for a twoperson family is $20,440. (We used the 2024 FPL rates
for this example. For current FPL rates, see HI 03001.020C.3.). We determine the subsidy income limits as follows:
$20,440 x 135% = $27,594
$20,440 x 140% = $28,616
$20,440 x 145% = $29,638
$20,440 x 150% = $30,660
Analysis: The couple’s countable income ($28,611.50) is greater than 135% of the FPL and less
than 140%. Therefore, Billy's award letter will state subsidy eligibility is 75% subsidy
starting November 1, 2023. If Billy's circumstances remain the same, Billy will receive
another letter stating starting January 1, 2024 the subsidy eligibility will change
from 75% to 100% due to a new law (the Inflation Reduction Act).