Medicare and Benefits Medicare and Benefits UpdateUpdate
20142014Legal Aid of the BluegrassLegal Aid of the Bluegrass
SHIP PROGRAMSHIP PROGRAM
Medicare & Benefits Updates- 2014Medicare & Benefits Updates- 2014
ACAACA Medicare Part A & BMedicare Part A & B Medicare Part C & DMedicare Part C & D Money Saving BenefitsMoney Saving Benefits
THE ACATHE ACA
The ACA and Health Insurance The ACA and Health Insurance MarketplacesMarketplaces
ACA created marketplaces for uninsured ACA created marketplaces for uninsured individuals and insured individuals with high individuals and insured individuals with high premiums to purchase health insurancepremiums to purchase health insurance
Insurance sold under the marketplace offered Insurance sold under the marketplace offered by private companies by private companies
Kentucky’s marketplace is called kynect Kentucky’s marketplace is called kynect (kynect.ky.gov)(kynect.ky.gov)
Over 600,000 Kentuckians are uninsuredOver 600,000 Kentuckians are uninsured
The ACA and Health Insurance The ACA and Health Insurance MarketplacesMarketplaces
Insurance plans will be placed into categories based Insurance plans will be placed into categories based on level of coverageon level of coverage Bronze, silver, gold and platinumBronze, silver, gold and platinum
Individuals can compare the coverage and determine Individuals can compare the coverage and determine which type is best for themwhich type is best for them
Assistance in the way of tax credits and cost sharing Assistance in the way of tax credits and cost sharing reductions are available to people to reduce the cost reductions are available to people to reduce the cost of premiumsof premiums To determine approximate credit and premium amounts To determine approximate credit and premium amounts
visit, visit, http://http://kff.orgkff.org/interactive/subsidy-calculator//interactive/subsidy-calculator/
The ACA and MedicaidThe ACA and Medicaid
Governor Beshear Governor Beshear expanded Medicaid to expanded Medicaid to include anyone with include anyone with income of 138% fpl or income of 138% fpl or belowbelow
Over 300,000 Over 300,000 Kentuckians will be Kentuckians will be eligible for Medicaid eligible for Medicaid benefits under the benefits under the expansionexpansion
Family Size
Monthly Income
1 $1,321
2 $1,784
3 $2,247
4 $2,710
The ACA and health care The ACA and health care marketplacesmarketplaces
Enrollment begins October 1 and ends March Enrollment begins October 1 and ends March 31 for the first year31 for the first year October 15 to December 7 in 2014 and beyondOctober 15 to December 7 in 2014 and beyond
Coverage is effective January 1 if enrollment Coverage is effective January 1 if enrollment happens prior to December 15happens prior to December 15
People on Medicare are not allowed to People on Medicare are not allowed to participate in the marketplaceparticipate in the marketplace
Medicare Part A & Medicare Part A & Part BPart B
Outpatient Mental Health Outpatient Mental Health CareCare
After Part B deductibleAfter Part B deductible For visits to diagnose conditionFor visits to diagnose condition
Beneficiaries pay 20% of Medicare-approved Beneficiaries pay 20% of Medicare-approved amountamount
For outpatient treatment (such as For outpatient treatment (such as psychotherapy)psychotherapy)
In this YearIn this Year Beneficiaries PayBeneficiaries Pay
20132013 35%35%
20142014 20%20%
National Mail Order Program for National Mail Order Program for Diabetic Testing SuppliesDiabetic Testing Supplies
Effective July 1, 2013Effective July 1, 2013 Includes all parts of the United States Includes all parts of the United States
including US Territoriesincluding US Territories To find a supplier, visit To find a supplier, visit http://http://
www.medicare.gov/supplierdirectory/search.htwww.medicare.gov/supplierdirectory/search.htmlml
Outpatient vs InpatientOutpatient vs Inpatient
Must be formally admitted to be considered Must be formally admitted to be considered inpatient inpatient
Outpatient services includeOutpatient services include Emergency Room visitsEmergency Room visits Observation services at a hospital- including over Observation services at a hospital- including over
night stays at the hospitalnight stays at the hospital Outpatient surgeryOutpatient surgery Lab tests and X-raysLab tests and X-rays
Outpatient vs InpatientOutpatient vs Inpatient
Always ask for inpatient or outpatient status if Always ask for inpatient or outpatient status if in the hospital for more than a few hoursin the hospital for more than a few hours
Outpatient status will affect admission to a Outpatient status will affect admission to a skilled nursing facilityskilled nursing facility
Medicare Part C & DMedicare Part C & D
Standard Part D Standard Part D Benefit ParametersBenefit Parameters
Benefit ParametersBenefit Parameters 20132013 20142014
DeductibleDeductible $325$325 $310$310
Initial Coverage LimitInitial Coverage Limit $2970$2970 $2850$2850
Out-of-Pocket ThresholdOut-of-Pocket Threshold $4750$4750 $3605$3605
Total Covered Drug Spending at OOP Total Covered Drug Spending at OOP ThresholdThreshold
$6954.52$6954.52 $6455$6455
Minimum Cost Sharing in Catastrophic Minimum Cost Sharing in Catastrophic CoverageCoverage
$2.65/$6.60$2.65/$6.60 $2.55/$6.35$2.55/$6.35
Extra Help CopaymentsExtra Help Copayments 20132013 20142014
InstitutionalizedInstitutionalized $0$0 $0$0
Receiving Home & Community Based Ser.Receiving Home & Community Based Ser. $0$0 $0$0
Up to or at 100% FPLUp to or at 100% FPL $1.15/$3.50$1.15/$3.50 $1.20/$3.60$1.20/$3.60
Full Extra HelpFull Extra Help $2.65/$6.60$2.65/$6.60 $2.55/$6.35$2.55/$6.35
Partial Extra Help (deductible/cost-sharing)Partial Extra Help (deductible/cost-sharing) $66/15%$66/15% $63/15%$63/15%
Part D Coverage Gap Part D Coverage Gap Discount ProgramDiscount Program
If beneficiaries reach the coverage gap in 2014If beneficiaries reach the coverage gap in 2014 52.5% discount on covered brand-name drugs52.5% discount on covered brand-name drugs
50% paid by drug manufacturer will still apply to getting out 50% paid by drug manufacturer will still apply to getting out of the donut holeof the donut hole
2.5% paid by Part D plan will not count toward TrOOP2.5% paid by Part D plan will not count toward TrOOP
28% discount on covered generic drugs28% discount on covered generic drugs Dispensing fees are not subject to the 52.5% discountDispensing fees are not subject to the 52.5% discount
Additional savings in coverage gap each year Additional savings in coverage gap each year Until 2020Until 2020
Improved Coverage in the Coverage GapImproved Coverage in the Coverage Gap
YearYear
What Beneficiaries Pay for What Beneficiaries Pay for Brand Name Drugs in the Brand Name Drugs in the
Coverage GapCoverage Gap
What Beneficiaries Pay for What Beneficiaries Pay for Generic Drugs in the Coverage Generic Drugs in the Coverage
GapGap
20132013 47.5%47.5% 79%79%
20142014 47.5%47.5% 72%72%
20152015 45%45% 65%65%
20162016 45%45% 58%58%
20172017 40%40% 51%51%
20182018 35%35% 44%44%
20192019 30%30% 37%37%
20202020 25%25% 25%25%
Landscape of Plans Landscape of Plans 100% of people with Medicare have access to a Medicare Advantage plan100% of people with Medicare have access to a Medicare Advantage plan
100% of people with Part D have access to a plan with lower premium than 100% of people with Part D have access to a plan with lower premium than what they paid in 2013what they paid in 2013
38% of people with Medicare Part D get Extra Help (also called the low-38% of people with Medicare Part D get Extra Help (also called the low-income subsidy, or LIS)income subsidy, or LIS)
$12.60 is the lowest monthly premium for a prescription drug plan$12.60 is the lowest monthly premium for a prescription drug plan
13 PDPs have a premium of $0 for people who qualify for Extra Help13 PDPs have a premium of $0 for people who qualify for Extra Help
340,165 people in Kentucky with Original Medicare took advantage of at 340,165 people in Kentucky with Original Medicare took advantage of at least one free preventive service through August 2013least one free preventive service through August 2013
People with Medicare in Kentucky have saved $141,019,279 on People with Medicare in Kentucky have saved $141,019,279 on prescription drugs in the Medicare Part D donut hole as a result of the prescription drugs in the Medicare Part D donut hole as a result of the Affordable Care Act.Affordable Care Act.
Landscape of Plans (PDP)Landscape of Plans (PDP) New PlansNew Plans
Transamerica MedicareRxTransamerica MedicareRx ChoiceChoice ClassicClassic
SymphonixSymphonix Rite Aid Value RxRite Aid Value Rx Value RxValue Rx
Humana Walmart RxHumana Walmart Rx Cigna Secure-XtraCigna Secure-Xtra
Plans That Are LeavingPlans That Are Leaving EnvisionRxPlus GoldEnvisionRxPlus Gold Humana Complete Humana Complete
Name ChangesName Changes 2013 Humana Walmart-Preferred Rx plan will be called Humana Preferred Rx Plan2013 Humana Walmart-Preferred Rx plan will be called Humana Preferred Rx Plan Cigna Plan One now Cigna Secure Cigna Plan One now Cigna Secure Cigna Plan Two now Cigna Secure-MaxCigna Plan Two now Cigna Secure-Max Cigna has purchased HealthSpring and will rename the HealthSpring plan to Cigna-Cigna has purchased HealthSpring and will rename the HealthSpring plan to Cigna-
HealthSpring RxHealthSpring Rx Reader’s Digest plan will change to HealthMarkets Value RxReader’s Digest plan will change to HealthMarkets Value Rx
SmartD Rx (purchased by Express Scripts) and SilverScript are still under CMS SmartD Rx (purchased by Express Scripts) and SilverScript are still under CMS sanction and were not included in Medicare Part D landscape datasanction and were not included in Medicare Part D landscape data
Landscape of Plans (PDP), cont’dLandscape of Plans (PDP), cont’d
StatisticStatistic 20142014 Change from 2013 to Change from 2013 to 20142014
Total Number of Part D Total Number of Part D Drug Plans Drug Plans
3030 -2-2
# of Enhanced Plans # of Enhanced Plans 1515 -2-2
# of Basic Plans# of Basic Plans 1515 00
# of $0 Deductible Plans# of $0 Deductible Plans 1414 -1-1
Lowest Cost PDP PlanLowest Cost PDP Plan $12.60*$12.60* -$2.40-$2.40
Lowest Premium for $0 Lowest Premium for $0 Deductible PlanDeductible Plan
$20.90**$20.90** -$8.20-$8.20
Number of LIS $0 Number of LIS $0 Premium PlansPremium Plans
1313 22
*Lowest Premium PDP for 2014: Humana Walmart Rx Plan**Lowest Premium $0 Deductible PDP for 2014: WellCare Classic
Premium Changes for Persons Premium Changes for Persons Staying in their Current PDPStaying in their Current PDP
StatisticStatistic 20142014 Change from Change from 2013 to 20142013 to 2014
Number of Plans with Number of Plans with Premium Premium DecreaseDecrease
1010 00
Number of Plans with Number of Plans with No Premium No Premium ChangeChange
00 00
Number of Plans with Number of Plans with Premium Premium IncreaseIncrease
1414 -7-7
% of People with % of People with Premium IncreasePremium Increase 73%73% -9%-9%
Weighted Average Increase for People Weighted Average Increase for People with a Premium Increasewith a Premium Increase
$5.26$5.26 $1.55$1.55
Landscape of Plans (MA)Landscape of Plans (MA)
New PlansNew Plans Anthem Senior Advantage Complete HMOAnthem Senior Advantage Complete HMO HumanaChoice H6609-(078-081)HumanaChoice H6609-(078-081)
Plans That Are LeavingPlans That Are Leaving Anthem Medicare Preferred Select PPOAnthem Medicare Preferred Select PPO 2013 non-regional HumanaChoice plans2013 non-regional HumanaChoice plans Today’s Options plansToday’s Options plans
Landscape of Plans (SNP)Landscape of Plans (SNP)
Minimal changesMinimal changes WellCare Access HMO-SNP for dual eligible WellCare Access HMO-SNP for dual eligible
individuals has expanded its covered countiesindividuals has expanded its covered counties
2013 Calendar Highlights2013 Calendar Highlights
Late September- CMS mails the Medicare & You Late September- CMS mails the Medicare & You handbookhandbook
September 30- Plans must provide Annual Notice of September 30- Plans must provide Annual Notice of Change/Evidence of Coverage to membersChange/Evidence of Coverage to members
October 1- Plans begin marketingOctober 1- Plans begin marketing October 1- 2014 plan data to be displayed on the October 1- 2014 plan data to be displayed on the
Medicare Plan FinderMedicare Plan Finder Mid-October- plan ratings updated on MPFMid-October- plan ratings updated on MPF October 15-Open Enrollment beingsOctober 15-Open Enrollment beings December 7- Open Enrollment endsDecember 7- Open Enrollment ends January 1- 2014 plan benefit period beginsJanuary 1- 2014 plan benefit period begins
Low-Performing Medicare Low-Performing Medicare Advantage and Drug PlansAdvantage and Drug Plans
Plans that receive average Part C or D Plans that receive average Part C or D summary rating of less than 3-stars for 3 years summary rating of less than 3-stars for 3 years in a rowin a row Indicates organization’s substantial failure to Indicates organization’s substantial failure to
comply with its Medicare contractcomply with its Medicare contract Ratings are on Medicare Plan Finder ToolRatings are on Medicare Plan Finder Tool Medicare & You does not have full, updated Medicare & You does not have full, updated
ratingsratings
Low-Performing Medicare Low-Performing Medicare Advantage PlansAdvantage Plans
Changes for low-performing plans in 2013Changes for low-performing plans in 2013 No online enrollment for low-performing plans No online enrollment for low-performing plans
Must contact plan directly to enrollMust contact plan directly to enroll
Enrolled beneficiaries may use Special Enrollment Enrolled beneficiaries may use Special Enrollment Period to move to a higher quality planPeriod to move to a higher quality plan
Will receive mailing from CMSWill receive mailing from CMS
CMS has option to terminate low-performing CMS has option to terminate low-performing contracts starting in 2015contracts starting in 2015
High Performing Medicare High Performing Medicare Drug PlansDrug Plans
5 Star Special Enrollment Period5 Star Special Enrollment Period Plans rated 5 Stars are indicated with a yellow Plans rated 5 Stars are indicated with a yellow
triangle with a star and the number 5 located in triangle with a star and the number 5 located in the centerthe center
SEP begins December 8 each yearSEP begins December 8 each year Beneficiaries can enroll into a 5 Star rated plan Beneficiaries can enroll into a 5 Star rated plan
up until Nov. 30 of the following yearup until Nov. 30 of the following year Only allowed one enrollment during the SEPOnly allowed one enrollment during the SEP SEP is extended to individuals currently enrolled SEP is extended to individuals currently enrolled
into a 5 Star planinto a 5 Star plan
Marketing Guidelines During Marketing Guidelines During Medicare Open EnrollmentMedicare Open Enrollment
Plans must disclose plan information, Plans must disclose plan information, including changes at least twice a yearincluding changes at least twice a year At time of enrollmentAt time of enrollment Annual Notice of ChangeAnnual Notice of Change
Marketing Guidelines During Marketing Guidelines During Medicare Open EnrollmentMedicare Open Enrollment
Plans can Plans can Offer gifts costing no more than $15 to potential Offer gifts costing no more than $15 to potential
enrollees (could include light snack)enrollees (could include light snack) Call existing members regarding enrollment into a Call existing members regarding enrollment into a
planplan Call beneficiaries that requested a phone callCall beneficiaries that requested a phone call Schedule in home appointments with beneficiaries Schedule in home appointments with beneficiaries
during a sales eventduring a sales event Sell non-health related products if the beneficiary Sell non-health related products if the beneficiary
contacts the plan and requests that informationcontacts the plan and requests that information
Marketing Guidelines During Marketing Guidelines During Medicare Open EnrollmentMedicare Open Enrollment
Plans CANNOTPlans CANNOT Conduct door-to-door solicitationConduct door-to-door solicitation Make outbound marketing calls (cold calling)Make outbound marketing calls (cold calling) Call beneficiaries to confirm receipt of mailed Call beneficiaries to confirm receipt of mailed
informationinformation Approach beneficiaries in common areas (parking Approach beneficiaries in common areas (parking
lots, hallways, lobbies, sidewalks, etc.)lots, hallways, lobbies, sidewalks, etc.) Call or visit beneficiaries that attended sales events Call or visit beneficiaries that attended sales events
unless express permission is given by the unless express permission is given by the beneficiarybeneficiary
Marketing Guidelines During Marketing Guidelines During Medicare Open EnrollmentMedicare Open Enrollment
Plans CANNOTPlans CANNOT Cross sell other non-health related insurance Cross sell other non-health related insurance
products during a MA or Part D sales products during a MA or Part D sales activity/presentation (annuities, life insurance, etc.)activity/presentation (annuities, life insurance, etc.)
Notices from CMS and SSANotices from CMS and SSA SeptemberSeptember
Social Security Notice to Review Eligibility for LISSocial Security Notice to Review Eligibility for LIS Plan Annual Notice of Change/Evidence of Plan Annual Notice of Change/Evidence of
CoverageCoverage Plan LIS Rider-from plan telling how much they get Plan LIS Rider-from plan telling how much they get
in 2014 towards Part D premium, deductibles and in 2014 towards Part D premium, deductibles and co-paymentsco-payments
Creditable Coverage letters from Employer/Union Creditable Coverage letters from Employer/Union plansplans
Loss of Deemed Status Notice-from SSA stating Loss of Deemed Status Notice-from SSA stating they are no longer eligible for LISthey are no longer eligible for LIS
Medicare & You handbooksMedicare & You handbooks
Notices from CMS and SSANotices from CMS and SSA OctoberOctober
Plan Non-Renewal NoticesPlan Non-Renewal Notices Change in Extra Help Co-Payment Notice- from Change in Extra Help Co-Payment Notice- from
SSA on orange paper explaining copayments levels SSA on orange paper explaining copayments levels will change in 2014will change in 2014
Reassignment Notices-Plan Termination-on blue Reassignment Notices-Plan Termination-on blue paper explaining that plan is terminating and they paper explaining that plan is terminating and they will be reassigned to a new planwill be reassigned to a new plan
Reassignment Notice-Premium Increase-on blue Reassignment Notice-Premium Increase-on blue paper explaining that will be re-assigned to a new paper explaining that will be re-assigned to a new plan due to the increase in their current plan plan due to the increase in their current plan premium which is above the benchmarkpremium which is above the benchmark
Notices from CMS and SSANotices from CMS and SSA
OctoberOctober MA Reassignment Notice-on blue paper explaining MA Reassignment Notice-on blue paper explaining
that the MA plan is terminating and they will be re-that the MA plan is terminating and they will be re-assigned to a Medicare drug plan for 2014assigned to a Medicare drug plan for 2014
NovemberNovember LIS Choosers Notice-on tan paper explaining if they LIS Choosers Notice-on tan paper explaining if they
chose a Plan on their own that the plan’s premium chose a Plan on their own that the plan’s premium has increased above the benchmark and they will has increased above the benchmark and they will pay a portion of the premiumpay a portion of the premium
Notices from CMS and SSANotices from CMS and SSA
NovemberNovember Non-Renewal Reminder Notice- reminds people who Non-Renewal Reminder Notice- reminds people who
do not get LIS that the plan is terminatingdo not get LIS that the plan is terminating Social Security Income Related Adjustment Amount Social Security Income Related Adjustment Amount
Notice- tell higher income beneficiaries about the Notice- tell higher income beneficiaries about the higher Part B and Part D premium adjustmentshigher Part B and Part D premium adjustments
Social Security LIS Redetermination Decision Social Security LIS Redetermination Decision Notice-informing beneficiaries of their LIS award for Notice-informing beneficiaries of their LIS award for 20142014
Social Security LIS and MSP Outreach Notice-Social Security LIS and MSP Outreach Notice-informs individuals of these two benefitsinforms individuals of these two benefits
Notices from CMS and SSANotices from CMS and SSA
DecemberDecember Social Security Benefit Rate Change Notice- tells people about benefit Social Security Benefit Rate Change Notice- tells people about benefit
payment changes due to cost of living increases, premium withholdings, payment changes due to cost of living increases, premium withholdings, etc.etc.
Reassign Formulary Notice- on blue paper informing individuals who get Reassign Formulary Notice- on blue paper informing individuals who get LIS and were affected by reassignment which of the Part D drugs they LIS and were affected by reassignment which of the Part D drugs they took in 2013 will be covered in their new 2014 Medicare plantook in 2013 will be covered in their new 2014 Medicare plan
JanuaryJanuary CMS Non-Renewal Action Notice- reminds people who do not get LIS CMS Non-Renewal Action Notice- reminds people who do not get LIS
and whose plan terminated to join a new drug planand whose plan terminated to join a new drug plan
FebruaryFebruary Consistent Poor Performer Notice- Informs people that they’re enrolled in Consistent Poor Performer Notice- Informs people that they’re enrolled in
a plan that has been identified as a consistent poor performer and a plan that has been identified as a consistent poor performer and encourages them to explore other plan options in their areaencourages them to explore other plan options in their area
Changes to Plan Finder ToolChanges to Plan Finder Tool
Session timeout redirects to Medicare.govSession timeout redirects to Medicare.gov Estimated annual costs rounded to nearest $10 instead Estimated annual costs rounded to nearest $10 instead
of $50of $50 30, 60, 90 day supply info on drug benefit summary 30, 60, 90 day supply info on drug benefit summary
pop-uppop-up Medication Therapy Management tab instead of linkMedication Therapy Management tab instead of link Show estimated full cost the plan charges MedicareShow estimated full cost the plan charges Medicare January 2014 – Will show costs for the rest of the January 2014 – Will show costs for the rest of the
year ONLYyear ONLY
Money Saving BenefitsMoney Saving Benefits
Extra Help With Drug CostsExtra Help With Drug Costs
Sometimes called Low Income Subsidy (LIS)Sometimes called Low Income Subsidy (LIS) People with lowest income and resourcesPeople with lowest income and resources
Pay no premiums or deductiblesPay no premiums or deductibles Have small or no copaymentsHave small or no copayments
Those with slightly higher income and resourcesThose with slightly higher income and resources Have a reduced deductibleHave a reduced deductible Pay a little more out of pocketPay a little more out of pocket
No coverage gap for people who qualify for LISNo coverage gap for people who qualify for LIS
Extra Help in 2013Extra Help in 2013
Group 1Group 1 Group 2Group 2 Group 3Group 3
PremiumPremium $0$0 $0$0 Sliding scale Sliding scale based on based on incomeincome
Deductible Deductible $325/year$325/year
$0$0 $0$0 $65$65
Coinsurance up Coinsurance up to $4,750 out to $4,750 out
of pocketof pocket
$1.15/$3.50 $1.15/$3.50 copaycopay
$2.65/$6.60 $2.65/$6.60 copaycopay
Up to 15% Up to 15% coinsurancecoinsurance
Catastrophic Catastrophic coveragecoverage
$0$0 $0$0 $2.65/$6.60 $2.65/$6.60 copaycopay
Medicare Savings ProgramsMedicare Savings Programs
Help from Medicaid to pay Medicare Help from Medicaid to pay Medicare premiumspremiums For people with limited income and resourcesFor people with limited income and resources May also pay Medicare deductibles and May also pay Medicare deductibles and
coinsurancecoinsurance Programs includePrograms include
Qualified Medicare Beneficiary (QMB)Qualified Medicare Beneficiary (QMB) Specified Low-income Medicare Beneficiary (SLMB)Specified Low-income Medicare Beneficiary (SLMB) Qualifying Individual (QI)Qualifying Individual (QI)
Medicare Savings ProgramsMedicare Savings Programs
Provides payment for Part A and Part B Provides payment for Part A and Part B premiums and deductibles and co-insurancepremiums and deductibles and co-insurance QMBQMB SLMBSLMB QIQI
Eligibility for QMBEligibility for QMB Provides assistance with Part B premium and Provides assistance with Part B premium and
offers additional insuranceoffers additional insurance Income not exceeding 100% FPLIncome not exceeding 100% FPL
$978 individual$978 individual $1313 couple$1313 couple
ResourcesResources $7,080 for an individual$7,080 for an individual $10,620 for married couple$10,620 for married couple
Eligibility for SLMBEligibility for SLMB
Benefit is limited to payment of Part B Benefit is limited to payment of Part B premiums onlypremiums only
Income not higher than 120% FPLIncome not higher than 120% FPL $1169 individual$1169 individual $1571 couple$1571 couple
ResourcesResources $7,080 for an individual$7,080 for an individual $10,620 for married couple$10,620 for married couple
Eligibility for QIEligibility for QI Benefit limited payment of Part B premiumsBenefit limited payment of Part B premiums Cannot be otherwise eligible for MedicaidCannot be otherwise eligible for Medicaid Income not higher than 135% FPLIncome not higher than 135% FPL
$1313 Individual$1313 Individual $1765 couple$1765 couple
ResourcesResources $7,080 for an individual$7,080 for an individual $10,620 for married couple$10,620 for married couple
SNAP BenefitsSNAP Benefits
Supplemental Nutrition Assistance Program Supplemental Nutrition Assistance Program (SNAP)(SNAP) Federally funded program to assist with Federally funded program to assist with
purchasing food purchasing food Must have resources (assets) below $3250 if age Must have resources (assets) below $3250 if age
65 or older or disabled (some exclusions including 65 or older or disabled (some exclusions including the home and its contents, personal property and the home and its contents, personal property and vehicles)vehicles)
Income requirements based on household size Income requirements based on household size Deductions to income such as medical expenses Deductions to income such as medical expenses
are allowedare allowed
SNAP- Income GuidelinesSNAP- Income Guidelines
Household SizeHousehold Size Gross Income for Elder or Gross Income for Elder or Disabled PersonDisabled Person
11 $1498$1498
22 $2023$2023
33 $2548$2548
44 $3074$3074
55 $3599$3599
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