Multipliers for Special populations

Part D has risk adjustment multipliers to account for higher spending by particular beneficiary groups.  A beneficiary is eligible for only one of the multipliers.  If a beneficiary is in both low-income and long-term institutionalized status, the latter multiplier applies.

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Table 1 contains the multipliers applied to the Part D risk factors for beneficiaries eligible for the low-income subsidy (LIS).  The LIS criteria are those set for 2010.  The dollar thresholds are adjusted for inflation each year.


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Table 1. Multipliers for Special Populations - The Low-Income Subsidy
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Subsidy Group			Multiplicative factor	
-------------			---------------------			
low-income Group 1			1.08		
------------------			----			
Medicaid dual eligibles, income < 100%FPL, assets < 2xSSI 
or income < 135%FPL and assets < 3xSSI	

			
						
low-income Group 2			1.05		
------------------			----			
Income < 135% FPL and assets > 3xSSI but < $10,000 single, < $20,000 couple
or Income 135% - 150% FPL and assets  < $10,000 single, < $20,000 couple	
 
 	 	 	 	
						
FPL =  Federal Poverty Level
---					
Year 2010						
Persons in family	48 Contiguous States and D.C.	Alaska	Hawaii			
						
	1			$10,830 		$13,530 $12,460 			
	2			14,570			 18,210	 16,760			
						
SSI = Supplemental Security Income Asset limit
--- 
Year 2010: $2,000 for a single; $3,000 for a married couple		

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Table 2 contains the multipliers applied to the Part D risk factors for beneficiaries eligible for the long-term institutionalized subsidy (LTI). The monthly criterion for the LTI subsidy is residence in a long-term care facility in a stay of at least 90 days. 

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Table 2. Multipliers for Special Populations - Long-term Institutionalized
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Group		Multiplicative factor
-----		---------------------						
Aged			1.08
----			----
Disabled (<65) 		1.21
--------		----					

 	 	 	 	 	 	 	 	 
								
