Transcript SPAP Chartbook Updated - The Commonwealth Fund

Rizzo, Fox, Trail, and Crystal, State Pharmacy Assistance Programs: A Chartbook—Updated and Revised, January 2007
Income Eligibility Requirements for SPAPs
as a Percentage of the Federal Poverty Level, 2003
•
In 2003, income thresholds for SPAPs ranged from 100% of the Federal Poverty Level (FPL) in Wyoming to 500%
of FPL in Massachusetts.
•
In 2003, the Federal Poverty Level was $8,980 for individuals and $12,120 for couples, so income eligibility in 2003
ranged from that level to $44,900 for singles and $60,600 for couples.
•
Income eligibility levels in Massachusetts and Nevada are for individuals who are applying for state subsidies to help
pay the insurance premium for the program. People with incomes above these levels can enroll in the programs at
the full premium if they meet the other eligibility requirements (e.g., age, residency).
•
Note that, since incomes and the cost of living vary among states, poorer states that have lower income
requirements may be able to reach the same proportion of residents as do more well-off states that have higher
income requirements.
•
Maine sets income eligibility higher (210% of FPL) for applications who spend 40% or more of their income on
prescription drugs, and Delaware has no income limits for applicants who spend 40% or more of their income on
prescription drugs. In addition, Missouri disregards income spent on Medicare premiums when calculating income
eligibility, effectively raising income eligibility levels from 135% of FPL to 144% of FPL.
•
In contrast, income limits for the Medicare Part D benefit are 150% of FPL for the partial low-income subsidy and
135% for the full low-income subsidy and there are no adjustments to these income levels for those with excessive
drug costs.
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