TN 13 (12-11)
HI 03030.025 Resource Limits for Subsidy Eligibility
Citations:
Soc. Sec. Act, §1860D-14(a)(3)(D)
A. Background for resource limits for subsidy eligibility
To be eligible for a subsidy, an individual or couple must have countable resources below certain limits prescribed by law that adjust annually based on changes in the consumer price index.
NOTE: If an individual or couple expects to use some of his or her resources for funeral or burial expenses DON’T COUNT $1500 per individual ($3000 for a married couple); the HIGHER resource level applies.
B. Policy for 2018 resource limits for subsidy eligibility
1. Individual
The two resource limits for an individual in 2018 are $7,560 and $12,600.
a. Countable resources are $12,600 or more
If countable resources are $12,600.01 or more, the individual is not eligible for any subsidy but can enroll in Part D.
b. Countable resources are $7,560 or less
If countable resources are $7,560 or less, the individual can be eligible for a subsidy depending on the amount of countable income.
c. Countable resources are greater than $7,560 but do not exceed $12,600
If countable resources are $7,560.01 or more but do not exceed $12,600, the individual can be eligible for a subsidy depending on countable income.
If his or her income is less than 135% of the Federal Poverty Level (FPL), he or she:
receives a 100% premium subsidy; and
is eligible for less help with co-pays and deductibles than an individual with $7,560 or less in countable resources, as explained in HI 03001.005.
d. Table:2018 resource limits for individuals
Individual’s Countable Resources | Individual’s Countable Income | Amount of the Premium Subsidy |
|---|
$7,560 or less | At or below 135% FPL | 100% |
$7,560.01 to $12,600 | At or below 135% FPL | 100% but less help with co-pays or deductibles |
$12,600 or less | More than 135% of FPL, but at or below 140% | 75% |
$12,600 or less | More than 140% of FPL but at or below 145% | 50% |
$12,600 or less | More than 145% of FPL but less than 150% | 25% |
$12,600.01 or more | Any amount | Not eligible for subsidy |
2. Married couple
The two resource limits for a married couple in 2018 are $11,340 and $25,150. The couple resource limits apply to a married couple who live together whether one or both members apply for the subsidy.
a. Countable resources are $25,150.01 or more
If countable resources are $25,150.01 or more, the couple is not eligible for any subsidy regardless of countable income, but can enroll in Part D.
b. Countable resources are $11,340 or less
If countable resources are $11,340 or less, the couple can be eligible for a subsidy depending on the amount of countable income.
c. Countable resources are greater than $11,340 but do not exceed $25,150
If countable resources are $11,340.01 or more but do not exceed $25,150, the couple can be eligible for a subsidy depending on countable income.
If their income is less than 135% FPL, the couple:
receives a 100% premium subsidy; and
is eligible for less help with co-pays and deductibles than the couple who has $11,340 or less in countable resources, as explained in HI 03001.005G.
d. Table: 2018 resource limits for married couples
Couple’s Countable Resources | Couple’s Countable Income | Amount of the Premium Subsidy |
|---|
$11,340 or less | At or below 135% FPL | 100% |
$11,340.01 to $25,150 | At or below 135% FPL | 100% but less help with co-pays or deductibles |
$25,150 or less | More than 135% of FPL, but at or below 140% | 75% |
$25,150 or less | More than 140% of FPL, but at or below 145% | 50% |
$25,150 or less | More than 145% of FPL but less than 150% | 25% |
$25,150.01 or more | Any amount | Not eligible for subsidy |
C. Policy for 2017 resource limits for subsidy eligibility
1. Individual
The resource limits for an individual in 2017 are $7,390 and $12,320.
2. Married couple
The resource limits for a married couple in 2017 are $11,090 and $24,600.
D. Policy for 2015 and 2016 resource limits for subsidy eligibility
1. Individual
The resource limits for an individual in 2015 and 2016 are $7,280 and $12,140.
2. Married couple
The resource limits for a married couple in 2015 and 2016 are $10,930 and $24,250.
E. Policy for 2014 resource limits for subsidy eligibility
1. Individual
The resource limits for an individual in 2014 are $7,160 and $11,940.
2. Married couple
The resource limits for a married couple in 2014 are $10,750 and $23,860.
F. Policy for 2013 resource limits for subsidy eligibility
1. Individual
The resource limits for an individual in 2013 are $7,080 and $11,800.
2. Married couple
The resource limits for a married couple in 2013 are $10,620 and $23,580.
G. Policy for 2012 resource limits for subsidy eligibility
1. Individual
The resource limits for an individual in 2012 are $6,940 and $11,570.
2. Married couple
The resource limits for a married couple in 2012 are $10,410 and $23,120.
H. Policy for 2011 resource limits for subsidy eligibility
1. Individual
The resource limits for an individual in 2011 are $6,680 and $11,140.
2. Married couple
The resource limits for a married couple in 2011 are $10,020 and $22,260.
I. Policy for 2009 and 2010 resource limits for subsidy eligibility
1. Individual
The resource limits for an individual in 2009 and 2010 are $6,600 and $11,010.
2. Married couple
The resource limits for a married couple in 2009 and 2010 are $9,910 and $22,010.
J. Policy for 2008 resource limits for subsidy eligibility
1. Individual
The resource limits for an individual in 2008 are $6,290 and $10,490.
2. Married couple
The resource limits for a married couple in 2008 are $9,440 and $20,970.
K. Policy for 2007 resource limits for subsidy eligibility
1. Individual
The resource limits for an individual in 2007 are $6,120 and $10,210.
2. Married couple
The resource limits for a married couple in 2007 are $9,190 and $20,410.
L. Policy for 2006 resource limits for subsidy eligibility
1. Individual
The resource limits for an individual in 2006 are $6,000 and $10,000.
2. Married couple
The resource limits for a married couple in 2006 are $9,000 and $20,000.
M. References