The new income and resource standards will be applied to all LIS applications filed on or after January 1, 2017.
2017 POVERTY GUIDELINES
ALL STATES (EXCEPT ALASKA AND HAWAII) AND D.C.
ANNUAL GUIDELINES
| FAMILY | PERCENT OF POVERTY GUIDELINE | ||||
| SIZE | |||||
| 100% | 135% | 140% | 145% | 150% | |
| 1 | 12,060.00 | 16,281.00 | 16,884.00 | 17,487.00 | 18,090.00 |
| 2 | 16,240.00 | 21,924.00 | 22,736.00 | 23,548.00 | 24,360.00 |
| 3 | 20,420.00 | 27,567.00 | 28,588.00 | 29,609.00 | 30,630.00 |
| 4 | 24,600.00 | 33,210.00 | 34,440.00 | 35,670.00 | 36,900.00 |
| 5 | 28,780.00 | 38,853.00 | 40,292.00 | 41,731.00 | 43,170.00 |
| 6 | 32,960.00 | 44,496.00 | 46,144.00 | 47,792.00 | 49,440.00 |
| 7 | 37,140.00 | 50,139.00 | 51,996.00 | 53,853.00 | 55,710.00 |
| 8 | 41,320.00 | 55,782.00 | 57,848.00 | 59,914.00 | 61,980.00 |
For family units of more than 8 members, add $4,180 for each additional member.
MONTHLY GUIDELINES
| FAMILY
SIZE |
PERCENT OF POVERTY GUIDELINE | ||||
| 100% | 135% | 140% | 145% | 150% | |
| 1 | 1,005.00 | 1,356.75 | 1,407.00 | 1,457.25 | 1,507.50 |
| 2 | 1,353.33 | 1,827.00 | 1,894.67 | 1,962.33 | 2,030.00 |
| 3 | 1,701.67 | 2,297.25 | 2,382.33 | 2,467.42 | 2,552.50 |
| 4 | 2,050.00 | 2,767.50 | 2,870.00 | 2,972.50 | 3,075.00 |
| 5 | 2,398.33 | 3,237.75 | 3,357.67 | 3,477.58 | 3,597.50 |
| 6 | 2,746.67 | 3,708.00 | 3,845.33 | 3,982.67 | 4,120.00 |
| 7 | 3,095.00 | 4,178.25 | 4,333.00 | 4,487.75 | 4,642.50 |
| 8 | 3,443.33 | 4,648.50 | 4,820.67 | 4,992.83 | 5,165.00 |
Resource Limits Used to Determine Eligibility for Low-Income Subsidy (LIS)
| LIS Level* | Marital Status | 2016 LIS Resource
Limit** |
2017 LIS Resource
Limit** |
| Full Subsidy LIS | Single | $8,780 | $8,890 |
| Married | $13,930 | $14,090 | |
| All Other LIS | Single | $13,640 | $13,820 |
| Married | $27,250 | $27,600 |
2017 Maximum LIS Beneficiary Cost-Sharing Table
|
Low–income Subsidy Category |
Deductible |
Copayment up to Out-of-Pocket Threshold* | Copayment above Out-of-pocket Threshold* |
| Institutionalized Full-Benefit Dual Eligible; or
Beneficiaries Receiving Home and Community- Based Services |
$0 | $0 | $0 |
| Full-Benefit Dual Eligible ≤ 100% FPL | $0 | $1.20 generic,
$3.70 brand |
$0 |
| Full-Benefit Dual Eligible > 100% FPL; or
Medicare Saving Program Participant (QMB-only, SLMB-only, or QI); or
Supplemental Security Income (but not Medicaid) Recipient; or
Applicant < 135% FPL with resources ≤ $8,890 ($14,090 if married)** |
$0 | $3.30 generic,
$8.25 brand |
$0 |
| Applicant < 150% FPL with resources between
$8,890 – $13,820 ($14,090 – $27,600 if married)** |
$82 | 15% | $3.30 generic,
$8.25 brand |
*Out-of-Pocket Threshold is $4,950 for 2017.
** Resource limits displayed include $1,500 per person for burial expenses.
*** Please Click Here to view Additional State information and to view the entire memorandum from CMS
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