Depicting different levels of Medicare and Medicaid
eligibility which include Standard Benefit:Greater than 150% above the
Federal Povery Level, Partial Subsidy:145-150% above Federal Poverty
Level, Partial Subsidy: 140-145% above Federal Poverty Level, Partial
Subsidy: 135-140% above Federal Poverty Level, Full Subsidy: Dual
eligible above poverty, with SSI (Supplemntal Security Income), MSP
(Medicare Savings Plan) and Medicare, and Dual Eligible Below Poverty,
this graph measures these different categories across time annualy
(January to December) and Monthly out-of-pocket payments (from
$0-$1500). The chart shows that a huge peak in out-of-pocket expenses
occurs for the Standard Benefit population between January and March
(from approximately $575 to $1400), with a slow decline in April (back
down to $1200), and a large drop in out-of-pocket expense in May
(falling to approximately $100),and then holding steady from June to
December (at $100). The Partial Subsidy: 145-150% above Federal Poverty
Level population showed a similar trend, with less dramatic increases.
While there was no initial spike in cost, in January, out-of-pocket
expense for this population was reported at almost $300, declining to
just above $200 in February, holding steady there until April where
another decline to less than $100 a month out-of-pocket expense for the
remainder of the year was reported. Partial Subsidy: 140-145% followed
the exact same pattern as Partial Subsidy: 145-150%. Partial Subsidy
135-140% followed the exact same pattern as well, with a plus/minus
margin of less than $100 consistently. The Full Subsidy category
reported a less than $50 out-of-pocket expense throughout the year, with
a minor decrease from April to May of approximately $10. The Dual
Eligibility category showed almost no out-of-pocket expense, with
approximately $20 from January to April, then dropping to just above $0
in May.
This gragh assumes $1,300/month for drug costs, three preferred and
three generic drugs, and premiums of $32.20/month.
All three Partial Subsidy categories are defined by asset limits of
$7,500/$12,000 (single/couple) for Medicare only <135% FPL (Federal
Poverty Level) and of $11,500/$23,000 for partial subsidy (135-150%
FPL).