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					                                                                                   Issue Paper #3 1/21/2005


          For 2006, the premium and cost-sharing amounts for various subsidy eligible
          groups are as follows:

FPL & Assets                  Percentage of Premium           Deductible   Copayment up to out-of-             Copayment
                              Subsidy Amount (1)                           pocket- limit                       above out-of-
                                                                                                               pocket-limit
Full-benefit dual eligible    100%*                           $0           $0                                  $0
individual-
institutionalized
individual
Full- benefit dual eligible   100%*                           $0           The lesser of: (1) an amount that   $0
individual- Income at or                                                   does not exceed $1-
below 100% FPL (non-                                                       generic/preferred multiple
institutionalized                                                          source and $3 –other drugs, or
individual)                                                                (2) the amount charged to other
                                                                           individuals below 135% FPL
                                                                           and with assets that do not
                                                                           exceed $6,000 (individuals) or
                                                                           $9,000 (couples)
Full benefit dual eligible    100%*                           $0           An amount that does not exceed      $0
individual- Income above                                                   $2- generic/preferred multiple
100% FPL (non-                                                             source and $5-other drugs
institutionalized
individual)
Other low-income              100%*                           $0           An amount that does not exceed      $0
beneficiary with income                                                    $2- generic/preferred multiple
below 135% FPL and                                                         source and $5 – other drugs.
with assets that do not
exceed $6,000
(individuals) or $9,000
(couples)
Other low-income              100%*                           $50          15% coinsurance                     An amount that
beneficiary with income                                                                                        does not exceed
below 135% FPL and                                                                                             $2-
with assets tat do not                                                                                         generic/preferred
exceed $6,000 but do not                                                                                       multiple source
exceed $10,000                                                                                                 drug or $5- other
(individuals) or with                                                                                          drugs
assets that exceed $9,000
but do not exceed $20,000
(couples)
Other low-income              Sliding scale premium subsidy   $50          15% coinsurance                     An amount that
beneficiary with income       (100%-0%)                                                                        does not exceed
at or above 135% FPL but                                                                                       $2 –
below 150% FPL, and                                                                                            generic/preferred
with assets that do not                                                                                        multiple source
exceed $10,000                                                                                                 drug or $5- other
(individuals) or $20,000                                                                                       drugs.
(couples)

               (1) Premium subsidy amount as defined in §423.780(b)
               * The percentage shown in the table is the greater of the low income benchmark
               premium amount or the lowest PDP premium for basic coverage in the region.

				
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Jun Wang Jun Wang Dr
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