Haw. Code R. § 17-1722-90

Current through September, 2024
Section 17-1722-90 - Benefits of the LIS program

The LIS program provides full or partial assistance with the subsidy for the coverage of the monthly premiums and cost-sharing related to Medicare part D to individuals based on the countable income of their households:

(1) Full benefit dual eligible individuals with countable income up to one hundred percent of the FPL shall be responsible for:
(A) The portion of the premium that exceeds the low income benchmark premium amount for basic coverage; and
(B) Co-payments.
(2) Full benefit dual eligible individuals above one hundred percent of the FPL, Medicare Savings Program beneficiaries, SSI recipients, and non-dual eligible individuals with countable income that does not exceed one hundred thirty-five percent of the FPL shall be responsible for:
(A) The portion of the premium that exceeds the low income benchmark premium amount for basic coverage; and
(B) Co-payments.
(3) Non-dual eligible individuals with income that exceeds one hundred thirty-five percent but does not exceed one hundred fifty percent of the FPL shall be responsible for:
(A) The portion of the monthly low income benchmark premium amount based on a sliding scale;
(B) A deductible;
(C) The co-insurance portion incurred with the Part D coverage gap; and
(D) Co-payments.
(4) Full benefit dual eligible individuals who are residing in a medical institution will not be subject to any cost-sharing related to Medicare part D.

Haw. Code R. § 17-1722-90

[Eff 12/25/06] (Auth: HRS § 346-14) (Imp: 42 C.F.R. §423.774; 423.904; Pub. L. 108-173 )