In the first year that the individual applies for the subsidy, we count the income
that the individual expects to receive in the 12-month period starting from the subsidy
computation month. The subsidy computation month in this example is June 2012 because
the individual filed a subsidy application and is entitled to HI/SMI in the same month.
EXAMPLE: Ms. White will be 65 on June 12, 2012. She files for retirement insurance benefits
(RIB), Medicare, and for the Part D subsidy on April 14, 2012. She is working full-time,
but plans to stop work and will receive her final paycheck on May 15, 2012. On Question
10, she states that she will earn wages of $11,300 in 2012. And on Question 13 she
indicates a stop-work month of May 2012. Her social security benefit will be $1,050
per month and she has no other income.
Her eligibility for the subsidy is determined based on her expected income for a period
of 12 months starting with her subsidy computation month, which is June 2012. The
subsidy determination system uses the income reported on her application and projects
it for 12 months starting in June 2012. Her annualized countable income will be $12,360
($1,050 x 12 months minus the $240 exclusion). The subsidy determination system compares
this amount to the 2012 FPL limits for a one-person household and results in a determination
that she is eligible for a 100% subsidy because her countable income is less than
135% of the FPL.
NOTE: Wages do not count for the purpose of determining her eligibility, because she stopped
working prior to her subsidy computation month (June 2012). Based on the stop-work
month alleged by Ms. White on her application, the subsidy determination system is
able to determine that she has no countable wages.
If Ms. White continued to work, all of her wages or estimated wages for the calendar
year in which she is filing would be input along with a stop work date (if applicable).
The subsidy determination system will project her earnings to determine the annualized