Medicare Prescription Drug Benefit: Estimates of Beneficiaries Who Fall Below Countable Income Thresholds, by State

Medicare Prescription Drug Benefit: Estimates of Beneficiaries Who Fall Below Countable Income Thresholds, by State

Order Code RS21675
Updated February 17, 2005
CRS Report for Congress
Received through the CRS Web
Medicare Prescription Drug Benefit:
Estimates of Beneficiaries Who Fall Below
Countable Income Thresholds, by State
Chris L. Peterson
Analyst in Social Legislation
Domestic Social Policy Division
Summary
The Medicare Prescription Drug Improvement and Modernization Act of 2003
(P.L. 108-173) establishes a prescription drug benefit that begins in 2006. The cost-
sharing for prescription drugs is reduced for certain beneficiaries, depending on their
income-to-poverty ratio and other factors. Using the most recent data, this report
provides state-by-state estimates of the percentage and number of beneficiaries who fall
below various low-income thresholds, using the definition of income specified in the
law. The asset (or “resource”) limits were not factored into the analysis. This report
will be updated to reflect new legislation or data.
The Medicare Prescription Drug Improvement and Modernization Act of 2003 (P.L.
108-173) establishes a prescription drug benefit, under Medicare Part D, that begins in
2006. The cost-sharing (for example, deductibles and coinsurance) for prescription drugs
is reduced for certain beneficiaries, depending on their income-to-poverty ratio and other
factors. Table 1 shows estimates of the percentage and number of noninstitutionalized
aged (age 65 or older) Medicare beneficiaries who fall below income thresholds relevant
to the Part D cost-sharing. Table 2 shows the same estimates except it is for all
noninstitutionalized beneficiaries, not just the aged.
Even if one qualifies for cost-sharing assistance based on income, that assistance
may be precluded by the beneficiary’s countable assets, or resources. This was not
accounted for in the estimates.
Table 3 summarizes the low-income provisions under Part D and is from CRS
Report RL31525, Beneficiary Cost-Sharing Under the Medicare Prescription Drug
Benefit (which has a full discussion of these low-income provisions). For additional
information, see also CRS Report RL31966, Overview of the Medicare Prescription
Drug, Improvement, and Modernization Act of 2003, and CRS Report RS21583,
Medicare Prescription Drug Plans: Comparison of Actuarial Values.
Congressional Research Service ˜ The Library of Congress

CRS-2
Table 1. Average Percentage and Number of Aged (65 and Older),
Noninstitutionalized Medicare Beneficiaries with Countable Incomes Below
Specified Levels, by State, 2001-2003
Below 100% of Poverty
Below 135% ofPpoverty
Below 150% of Poverty
Total Avg
State
Number of
Percentage
Number
Percentage
Number
Percentage
Number
Beneficiaries
Alabama
18.7% ± 2.6%
**
103,000
32.9% ± 3.1% **
181,000
38.3% ± 3.2% **
210,000
549,000
Alaska
18.3% ± 3.4%
7,000
31.1% ± 4%
13,000
36.8% ± 4.2%
15,000
41,000
Arizona
9.7% ± 2.1%
*
63,000
23.3% ± 3% *
150,000
29% ± 3.3% *
187,000
645,000
Arkansas
19.5% ± 2.6%
**
73,000
34.6% ± 3.2% **
129,000
40.6% ± 3.3% **
151,000
373,000
California
14.6% ± 1.3%
475,000
31.7% ± 1.7% **
1,030,000
38.7% ± 1.8% ** 1,259,000
3,251,000
Colorado
13.1% ± 2.2%
53,000
25.6% ± 2.9%
104,000
30.9% ± 3.1% *
126,000
406,000
Connecticut
9.9% ± 1.6%
*
46,000
19.9% ± 2.2% *
92,000
25.4% ± 2.4% *
118,000
463,000
Delaware
9.9% ± 2.1%
*
9,000
20.1% ± 2.8% *
19,000
24.3% ± 3% *
23,000
94,000
DC
23.3% ± 3.4%
**
14,000
37.2% ± 3.8% **
22,000
41.8% ± 3.9% **
24,000
58,000
Florida
17% ± 1.3%
**
449,000
29.4% ± 1.5%
778,000
36.3% ± 1.6%
962,000
2,646,000
Georgia
18.8% ± 3%
**
135,000
33.8% ± 3.7% **
242,000
38.6% ± 3.8% **
277,000
717,000
Hawaii
20% ± 2.6%
**
31,000
33.5% ± 3.1% **
51,000
38.2% ± 3.2% **
58,000
153,000
Idaho
8.2% ± 2%
*
12,000
19.9% ± 3% *
29,000
26.4% ± 3.2% *
38,000
144,000
Illinois
13.3% ± 1.5%
*
187,000
25.2% ± 2% *
354,000
31.7% ± 2.1% *
444,000
1,401,000
Indiana
11.8% ± 1.8%
*
88,000
28.1% ± 2.6%
208,000
35.6% ± 2.7%
264,000
741,000
Iowa
12% ± 1.9%
*
46,000
23.6% ± 2.5% *
91,000
29.1% ± 2.7% *
113,000
387,000
Kansas
12.6% ± 2.1%
*
43,000
27.7% ± 2.7%
94,000
32.5% ± 2.9%
111,000
341,000
Kentucky
15% ± 2.3%
77,000
28.9% ± 2.9%
149,000
37% ± 3.1%
191,000
515,000
Louisiana
17.8% ± 2.8%
87,000
35.4% ± 3.5% **
173,000
41.1% ± 3.6% **
201,000
488,000
Maine
15.3% ± 1.9%
30,000
31.5% ± 2.4% **
62,000
38.4% ± 2.5% **
75,000
196,000
Maryland
13.8% ± 2.2%
81,000
25.8% ± 2.8%
151,000
30.8% ± 2.9% *
181,000
586,000
Massachusetts
18.3% ± 2.1%
**
145,000
31.6% ± 2.6% **
251,000
38.4% ± 2.7% **
305,000
794,000
Michigan
12.7% ± 1.6%
*
141,000
22.8% ± 2% *
254,000
28.2% ± 2.2% *
313,000
1,111,000
Minnesota
12.1% ± 2.2%
*
60,000
22.8% ± 2.8% *
113,000
28.7% ± 3% *
141,000
493,000
Mississippi
25.7% ± 3.4%
**
77,000
43% ± 3.9% **
129,000
48.9% ± 3.9% **
147,000
301,000
Missouri
11.3% ± 1.9%
*
79,000
22.4% ± 2.5% *
155,000
27.8% ± 2.7% *
193,000
694,000
Montana
13.4% ± 2.4%
16,000
27.7% ± 3.2%
34,000
34.3% ± 3.4%
42,000
122,000
Nebraska
12.8% ± 2.2%
*
25,000
23.7% ± 2.9% *
47,000
31.5% ± 3.1%
62,000
198,000
Nevada
12.8% ± 2.2%
*
29,000
24.7% ± 2.8% *
57,000
30.8% ± 3% *
71,000
229,000
New Hampshire 9.9% ± 1.8%
*
15,000
21.2% ± 2.5% *
32,000
29.2% ± 2.8% *
44,000
152,000
New Jersey
14.1% ± 1.7%
151,000
25.3% ± 2.1% *
272,000
31.7% ± 2.2% *
340,000
1,075,000
New Mexico
18.5% ± 3%
**
43,000
30.5% ± 3.6%
70,000
35.4% ± 3.7%
81,000
230,000
New York
19% ± 1.3%
**
438,000
31.5% ± 1.6% **
725,000
37.8% ± 1.7% **
870,000
2,301,000
North Carolina
19% ± 2.2%
**
179,000
34.9% ± 2.6% **
329,000
40.5% ± 2.7% **
382,000
943,000
North Dakota
13.4% ± 2.1%
11,000
27.5% ± 2.8%
23,000
34.7% ± 3%
29,000
82,000
Ohio
12.6% ± 1.5%
*
168,000
24.7% ± 2% *
329,000
30% ± 2.1% *
398,000
1,330,000
Oklahoma
15.4% ± 2.3%
68,000
28% ± 2.9%
124,000
33.3% ± 3%
147,000
444,000
Oregon
9.1% ± 2%
*
35,000
22.7% ± 2.9% *
87,000
27.2% ± 3% *
105,000
385,000
Pennsylvania
12.3% ± 1.3%
*
215,000
24.9% ± 1.7% *
432,000
31.8% ± 1.8% *
553,000
1,738,000
Rhode Island
16.4% ± 2%
24,000
32.1% ± 2.5% **
47,000
38.9% ± 2.6% **
57,000
145,000
South Carolina
20.5% ± 2.5%
**
106,000
34.6% ± 3% **
179,000
39.9% ± 3.1% **
207,000
517,000
South Dakota
13.4% ± 2%
13,000
31.6% ± 2.7% **
32,000
36.2% ± 2.8%
36,000
100,000
Tennessee
15.9% ± 2.7%
96,000
32.3% ± 3.5% **
195,000
39% ± 3.6% **
235,000
604,000
Texas
21.7% ± 1.8%
**
428,000
35.3% ± 2.1% **
697,000
41.1% ± 2.2% **
813,000
1,975,000
Utah
11.8% ± 2.7%
*
20,000
20.9% ± 3.4% *
35,000
26.5% ± 3.7% *
45,000
169,000
Vermont
13.3% ± 2.1%
10,000
28.8% ± 2.8%
21,000
35% ± 3%
25,000
72,000
Virginia
14.4% ± 2.3%
113,000
25.5% ± 2.9% *
201,000
31.2% ± 3% *
245,000
786,000
Washington
12.2% ± 2.3%
*
75,000
21.1% ± 2.9% *
130,000
26.4% ± 3.1% *
163,000
617,000
West Virginia
15.7% ± 2%
43,000
31.5% ± 2.6% **
87,000
37.1% ± 2.7%
103,000
277,000

CRS-3
Below 100% of Poverty
Below 135% ofPpoverty
Below 150% of Poverty
Total Avg
State
Number of
Percentage
Number
Percentage
Number
Percentage
Number
Beneficiaries
Wisconsin
11.2% ± 1.8%
*
72,000
20.4% ± 2.4% *
132,000
26.4% ± 2.6% *
170,000
645,000
Wyoming
11% ± 2.1%
*
6,000
25.5% ± 3% *
14,000
34% ± 3.2%
19,000
57,000
United States
15.3% ± 0.3%
5,012,000 28.5% ± 0.4%
9,354,000 34.7% ± 0.4%
11,369,000
32,782,000
Source: Table prepared by the Congressional Research Service based on data from the March supplement of the Current Population Survey, 2002-
2004.

Notes: Even if one qualifies for cost-sharing assistance based on income, that assistance may be precluded by the beneficiary’s countable assets,
or resources, a topic not addressed in this report. Income is determined based on the definition of countable income for Supplemental Security
Income, not by total family income. The Department of Health and Human Services’ federal poverty guidelines are used rather than the Census
Bureau’s federal poverty threshold. The range given for the percentages reflect the 90% confidence interval. These demonstrate that, because the
estimates are based on a portion of the entire aged Medicare population, the estimates are subject to variability. The size of the confidence intervals
depends primarily on sample size. A 90% confidence interval means that if all possible samples were surveyed under the same sample design and
general conditions, the estimated percentage in each income category would lie within the confidence interval 9 out of 10 times. The number of
beneficiaries is based on the corresponding percentage point estimate. The number of beneficiaries is subject to the same kind of variability as the
percentage, but the 90% confidence interval is not provided because of space constraints.

* Indicates percentage of beneficiaries is statistically lower than the national rate, at the 90% confidence level.
** Indicates the percentage of beneficiaries is statistically higher than the national rate, at the 90% confidence level.
Table 2. Average Percentage and Number of Noninstitutionalized Medicare
Beneficiaries (Aged and Disabled) with Countable Incomes Below Specified Levels,
by State, 2001-2003
Below 100% of Poverty
Below 135% of Poverty
Below 150% of Poverty
Total Avg
State
Number of
Percentage
Number
Percentage
Number
Percentage
Number
Beneficiaries
Alabama
24.3% ± 4% **
171,000
39.7% ± 4.6% **
280,000
44.9% ± 4.7% **
317,000
706,000
Alaska
23.7% ± 5.4%
12,000
38.5% ± 6.1%
20,000
44.1% ± 6.3%
23,000
52,000
Arizona
12.1% ± 3.5% *
90,000
26% ± 4.7% *
193,000
31.8% ± 5% *
236,000
743,000
Arkansas
25.6% ± 4.2% **
120,000
40.3% ± 4.7% **
189,000
46% ± 4.8% **
216,000
469,000
California
17.6% ± 2.1%
671,000
35.1% ± 2.6%
1,338,000
41.8% ± 2.7% ** 1,595,000
3,813,000
Colorado
17.8% ± 3.9%
85,000
30.4% ± 4.7%
145,000
35.8% ± 4.8%
170,000
476,000
Connecticut
13.7% ± 2.9% *
72,000
23.9% ± 3.6% *
126,000
29.6% ± 3.9% *
156,000
528,000
Delaware
13.7% ± 3.5% *
15,000
24.8% ± 4.4% *
28,000
29.6% ± 4.7% *
33,000
113,000
DC
29.1% ± 5.4% **
20,000
42.8% ± 5.9% **
30,000
47.5% ± 5.9% **
33,000
70,000
Florida
19.6% ± 2.1%
590,000
32.1% ± 2.4%
967,000
39% ± 2.5%
1,174,000
3,011,000
Georgia
23.2% ± 4.7%
212,000
39% ± 5.5% **
355,000
44% ± 5.5%
401,000
911,000
Hawaii
24.2% ± 4.3% **
42,000
37.3% ± 4.8%
65,000
41.6% ± 4.9%
73,000
175,000
Idaho
11.6% ± 3.6% *
19,000
23.2% ± 4.8% *
38,000
29.7% ± 5.1% *
49,000
164,000
Illinois
18.1% ± 2.6%
300,000
30.8% ± 3.1%
511,000
36.9% ± 3.3%
611,000
1,658,000
Indiana
16.4% ± 3.2%
143,000
32.1% ± 4%
280,000
39.3% ± 4.2%
343,000
872,000
Iowa
15.4% ± 3.2% *
68,000
26.8% ± 4% *
119,000
32.2% ± 4.2% *
143,000
443,000
Kansas
16.5% ± 3.5%
64,000
31.6% ± 4.3%
123,000
36.4% ± 4.5%
142,000
390,000
Kentucky
19.2% ± 3.7%
123,000
34.4% ± 4.4%
220,000
41.7% ± 4.6%
267,000
640,000
Louisiana
20.6% ± 4.4%
122,000
37.7% ± 5.3%
223,000
43.3% ± 5.4%
256,000
591,000
Maine
19.7% ± 3.1%
46,000
36.1% ± 3.7%
83,000
42.7% ± 3.8%
99,000
231,000
Maryland
18.1% ± 3.7%
121,000
29.3% ± 4.4%
196,000
34.4% ± 4.6%
230,000
668,000
Massachusetts
20.4% ± 3.4%
180,000
34% ± 4%
300,000
40.5% ± 4.2%
357,000
882,000
Michigan
18.2% ± 2.8%
246,000
29.1% ± 3.3% *
394,000
34.2% ± 3.4% *
463,000
1,354,000
Minnesota
14.5% ± 3.6% *
80,000
25.8% ± 4.4% *
143,000
31.4% ± 4.7% *
174,000
553,000
Mississippi
31.6% ± 5.2% **
123,000
47.7% ± 5.6% **
186,000
54.2% ± 5.6% **
212,000
390,000
Missouri
16.3% ± 3.4%
131,000
27.4% ± 4.1% *
219,000
32.2% ± 4.3% *
258,000
801,000
Montana
16.5% ± 3.9%
24,000
30.5% ± 4.8%
45,000
37.6% ± 5.1%
55,000
147,000
Nebraska
15.8% ± 3.7%
36,000
27% ± 4.6% *
61,000
34.9% ± 4.9%
79,000
225,000

CRS-4
Below 100% of Poverty
Below 135% of Poverty
Below 150% of Poverty
Total Avg
State
Number of
Percentage
Number
Percentage
Number
Percentage
Number
Beneficiaries
Nevada
15.2% ± 3.5% *
40,000
28.1% ± 4.4% *
74,000
33.9% ± 4.7% *
90,000
265,000
New Hampshire
12.8% ± 3.1% *
22,000
24.7% ± 4% *
42,000
33% ± 4.4% *
57,000
172,000
New Jersey
18.7% ± 2.8%
230,000
30.5% ± 3.3%
375,000
36.4% ± 3.5%
447,000
1,230,000
New Mexico
26.4% ± 5% **
76,000
38.7% ± 5.5% **
111,000
43.2% ± 5.6%
125,000
288,000
New York
22.5% ± 2.2% **
599,000
35% ± 2.5%
934,000
41.1% ± 2.5%
1,096,000
2,668,000
North Carolina
25.7% ± 3.5% **
307,000
40.8% ± 3.9% **
487,000
46.5% ± 4% **
555,000
1,193,000
North Dakota
15.5% ± 3.5% *
14,000
29.8% ± 4.4%
27,000
36.5% ± 4.6%
33,000
91,000
Ohio
16.6% ± 2.6% *
256,000
29.1% ± 3.2% *
451,000
34.6% ± 3.3% *
535,000
1,549,000
Oklahoma
19.7% ± 3.9%
101,000
32.8% ± 4.6%
169,000
37.8% ± 4.7%
194,000
514,000
Oregon
14.9% ± 3.6% *
69,000
29% ± 4.6%
135,000
33.5% ± 4.8% *
155,000
465,000
Pennsylvania
16% ± 2.2% *
317,000
28.7% ± 2.7% *
570,000
35.2% ± 2.8% *
698,000
1,982,000
Rhode Island
19.9% ± 3.3%
33,000
35.1% ± 3.9%
58,000
42% ± 4.1%
70,000
166,000
South Carolina
28.3% ± 4.1% **
188,000
41.3% ± 4.5% **
275,000
46.2% ± 4.5% **
307,000
665,000
South Dakota
17.3% ± 3.4%
20,000
35% ± 4.3%
39,000
39.3% ± 4.4%
44,000
113,000
Tennessee
21.6% ± 4.4%
168,000
38.9% ± 5.2% **
301,000
44.6% ± 5.3% **
346,000
775,000
Texas
26.1% ± 3% **
601,000
39.9% ± 3.3% **
919,000
45.2% ± 3.4% ** 1,043,000
2,306,000
Utah
16.5% ± 4.7%
32,000
25.4% ± 5.6% *
50,000
31.4% ± 5.9% *
62,000
196,000
Vermont
17.9% ± 3.6%
15,000
33% ± 4.4%
28,000
39.2% ± 4.6%
34,000
86,000
Virginia
19.1% ± 3.8%
181,000
31.2% ± 4.5%
295,000
37.1% ± 4.7%
350,000
945,000
Washington
16.5% ± 3.9%
119,000
25.1% ± 4.6% *
182,000
30.2% ± 4.9% *
218,000
724,000
West Virginia
20.8% ± 3.2%
74,000
36.5% ± 3.8%
130,000
42% ± 3.9%
150,000
357,000
Wisconsin
16.1% ± 3.2% *
122,000
26.1% ± 3.9% *
198,000
32.1% ± 4.1% *
243,000
758,000
Wyoming
16.7% ± 3.8%
11,000
30.7% ± 4.8%
20,000
38.4% ± 5%
25,000
66,000
United States
19.5% ± 0.5%
7,526,000
33% ± 0.6%
12,750,000 38.9% ± 0.7%
15,041,000
38,649,000
Source: Table prepared by the Congressional Research Service based on data from the March supplement of the Current Population Survey, 2002-
2004.

Notes: Even if one qualifies for cost-sharing assistance based on income, that assistance may be precluded by the beneficiary’s countable assets,
or resources, a topic not addressed in this report. Income is determined based on the definition of countable income for Supplemental Security
Income, not by total family income. The Department of Health and Human Services’ federal poverty guidelines are used rather than the Census
Bureau’s federal poverty threshold. The range given for the percentages reflect the 90% confidence interval. These demonstrate that, because the
estimates are based on a portion of the entire Medicare population, the estimates are subject to variability. The size of the confidence intervals
depends primarily on sample size. The number of beneficiaries is subject to the same kind of variability as the percentage, but the 90% confidence
interval is not provided because of space constraints.

* Indicates percentage of beneficiaries is statistically lower than the national rate, at the 90% confidence level.
** Indicates the percentage of beneficiaries is statistically higher than the national rate, at the 90% confidence level.

CRS-5
Source of Data. The state-by-state percentages presented in this report were
calculated using the March supplement of the Current Population Survey (CPS). The
CPS March supplement is a survey of approximately 99,000 households selected to be
demographically representative of the civilian noninstitutionalized population of the
United States. The analyses in this report were based on data from the CPS for 2001,
2002 and 2003. The sample sizes available for many states are small, especially when
examining a subset of the sample like Medicare beneficiaries over the age of 65. Small
sample sizes increase the likelihood that the characteristics of the survey participants
differ from the characteristics of the population they are meant to represent, which is
known as sampling error. To increase the reliability of state-level estimates, multiple-
year estimates were calculated.
Income Defined. In P.L. 108-173, income is counted according to Supplemental
Security Income (SSI) eligibility guidelines. As a result, appropriately estimating the
number of individuals who may be eligible for assistance under the law requires a more
in-depth analysis than simply looking at individuals’ or families’ reported total income.
The estimates of income used in this report were obtained by taking respondents’ total
income as reported in the CPS and subtracting from it the amounts and types of income
specified according to SSI eligibility rules as follows.
Income was divided into two categories — earned income, which consists of the CPS
variables for wages and self-employment earnings, and unearned income. The CPS
gathers information on 17 types of unearned income. Two of these are not considered
income for SSI purposes: education assistance and child support payments.1 The amount
of countable unearned income was reduced by up to $240 per year ($20 per month). If
that maximum amount was not reached (that is, if unearned income was less than $240
for the year), then the remainder of the $240 disregard was subtracted from earned
income.2 Countable earned income was reduced by an additional $780 per year ($65 per
month). Once the remaining countable earned income was calculated, if there was any
left, half of it was subtracted, and the amount that remained was counted as earned
income. The couple’s or individual’s countable earned and unearned incomes were then
added together and compared to the federal poverty guidelines.
Poverty Defined. The poverty guidelines are published by the Department of
Health and Human Services and are used primarily for determining eligibility for many
federal programs, which is why the guidelines are used in this analysis. The poverty
thresholds, although more commonly used for poverty-related analyses, are a different
measure of poverty updated by the Census Bureau, used primarily for statistical purposes.
The 2004 poverty guidelines for an individual living alone in the 48 contiguous states are
$9,310; for a family of two, the guideline is $12,490. In Alaska, the guidelines are
$11,630 for an individual living alone and $15,610 for a family of two. In Hawaii, the
guidelines are $10,700 for an individual living alone and $14,360 for a family of two.
1 Child support payments only count as income under SSI when determining eligibility for a child
for whom those payments are received.
2 SSI, public assistance welfare, disability payments and financial assistance payments are
considered unearned income when calculating total income. However, they are excluded when
calculating how much of the $240 disregard a beneficiary will receive. The CPS variable for
“financial assistance payments” is assumed to be state or nonprofit assistance.

CRS-6
Table 3. Summary of Prescription Drug Coverage for Low-Income Individuals in Part D, 2006
Noninstitutionalized Dual
All Other Medicare
Eligibles with Countable Income
Dual Eligibles with
Beneficiaries with
Institutionalizeda Dual
Above 100% of Poverty;
Countable Incomec at or
Countable Income Below
Eligiblesb
Medicare Beneficiaries with
below 100% of Poverty
150% of Poverty Plus
Countable Income Below 135%
Assets Testd
of Poverty Plus Assets Testd
Monthly premiume
$0
$0
$0-$35
Cost sharing for first
$250 of drug costs
$0
$0
$50
(annual deductible)
No cost-sharing or
Cost-sharing for drug
premium
$1/generic or preferred
$2/generic or preferred multiple-
costs from $250 to $5100
multiple-source drug,f
source drug,f
15%
(copayment or
$3 for all others
$5 for all others
coinsurance rate)
Cost-sharing for drug
$2/generic or preferred
costs exceeding $5100
$0
$0
multiple-source drug,f
(copayment)
$5 for all others
Source: Congressional Research Service (CRS) Report RL31525, Beneficiary Cost-Sharing Under the Medicare Prescription Drug Benefit, by Chris L. Peterson and Jim S. Hahn.
a. To be considered “institutionalized,” dual eligibles must be an inpatient in a Medicaid-certified medical institution or nursing facility, according to 1902(q)(1)(B) of the Social
Security Act, as amended.
b. “Dual eligibles” are those Medicare beneficiaries who are also enrolled to receive the full benefits of their state’s Medicaid program.
c. “Countable income” means the amount of income counted for determining eligibility for Supplemental Security Income (SSI), defined in Section 1612 of the Social Security Act,
as amended. “Poverty” refers to the federal poverty guidelines published by the Department of Health and Human Services.
d. The assets test refers to the amount of assets counted for determining eligibility for SSI, defined in Section 1613 of the Social Security Act, as amended. To qualify in the below
135% of poverty category in 2006, countable assets (resources) are limited to $6,000 for an individual and $9,000 for a married couple. To qualify in the category below 150%
of poverty, countable assets are limited to $10,000 for an individual and $20,000 for a couple.
e. Additional amounts may be required for prescription drug plans with relatively high premiums. The full $35 premium is an estimate from the Congressional Budget Office (CBO).
f. A “multiple-source drug” is a covered outpatient prescription drug for which there are two or more drug products rated as therapeutically and pharmaceutically equivalent by the
Food and Drug Administration.