In case you missed it, NCOA has updated the Part D Low-Income Subsidy/Extra Help eligibility chart for 2021, using the latest Federal Poverty Guidelines.

 

It is both attached and you also can download from: https://www.ncoa.org/wp-content/uploads/part-d-lis-eligibility-and-benefits-chart.pdf.

 

We are currently working on updating the state eligibility chart for Medicare Savings Programs and will circulate that once it is ready.

 

An important reminder: There is often a lag time from when the poverty guidelines are announced and when CMS & Social Security post the new year’s eligibility criteria. As of today, the Social Security POMS (https://secure.ssa.gov/apps10/poms.nsf/lnx/0603001020) has not updated the Extra Help income eligibility limits for 2021 (resource limits were updated late last year), nor has CMS updated the MSP criteria (usually posted at https://www.medicaid.gov/medicaid/eligibility/seniors-medicare-and-medicaid-enrollees/index.html).

 

Last year, SSA provided us this helpful guidance around whether to submit an LIS application using the new income criteria before it’s published:

 

Applications may be:

 

• Denied if the resources exceed 2021 resource limits (usually announced by Health and Human Services (HHS) in November of the prior year); or

 

• Awarded if the subsidy level is 135% or less using prior year’s FPL table rates.

 

If neither of the situations in the two prior bulleted items applies to the claimant, the application is placed in “Hold” status, pending receipt of the new FPL table.”

 

You should continue to work with your state Medicaid agency to see whether they have updated their criteria; some state policy manuals indicate that the previous year’s eligibility criteria remain in effect until March 1, so be sure to check with your state. We continue to advocate with CMS that they should be more prompt about releasing the new guidelines once the FPLs are announced in January.

 

 

Brandy Bauer
Associate Director, Center for Benefits Access
Office: 571-527-3911
xxxxxx@ncoa.org

National Council on Aging
251 18th St S, Suite 500
Arlington, VA 22202
ncoa.org | @NCOAging

 

 

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