For more information, and to see what forms of documentation are needed for evidence of low-income status:
Part D Full Subsidy — Non Full Benefit Dual
Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources below 9,900 (individuals in 2022) or $15,600 (couples, 2022)
Eligible for QMB/SLMB/QI, SSI or applied and income at or below 135% FPL and resources below 9,470 (individuals in 2021) or $14,960 (couples, 2021)
Eligible Full Subsidy Parameters: |
2022 |
2021 |
Deductible |
$0 |
$0 |
Maximum Copayments up to Out-of-Pocket Threshold |
Generic / Preferred Multi-Source Drug |
$3.95 |
$3.70 |
Other Drugs |
$9.85 |
$9.20 |
Maximum Copay above Out-of-Pocket Threshold |
$0 |
$0 |
Partial Subsidy Parameters
Applied and income below 150% FPL and resources below $15,510 (individual, 2022) or $30,950 couples, 2022)
Applied and income below 150% FPL and resources below $14,790 (individual, 2021) or $29,520 couples, 2021)
Partial Subsidy Parameters: |
2022 |
2021 |
Deductible |
$99 |
$92 |
Coinsurance up to Out-of-Pocket Threshold |
15% |
15% |
Maximum Copayments up to Out-of-Pocket Threshold |
Generic / Preferred Multi-Source Drug |
$3.95 |
$3.70 |
Other Drugs |
$9.85 |
$9.20 |