SeniorCare Annual Income Limits

Your annual income determines your level of coverage in SeniorCare and how much SeniorCare will cover. See the table below for out-of-pocket expenses and benefits for each level of participation.

SeniorCare 2020 Annual Income Limits and Out of Pocket Expenses by Level of Participation
Level 1 Income Limits Level 1 Out-of-Pocket Expenses

Income at or below 160% of the FPL

Individual: $20,416
Couple: $27,584

  • No deductible or spenddown.
  • $5 copay for each covered generic prescription drug.
  • $15 copay for each covered brand name prescription drug.
Level 2A Income Limits Level 2A Out-of-Pocket Expenses
Income between 160% and 200% of the FPL

Individual: $20,417-$25,520
Couple: $27,585-$34,480
  • $500 deductible per person.
  • Pay the SeniorCare rate for covered drugs until the $500 deductible is met.
  • After $500 deductible is met, pay a $5 copay for each covered generic prescription drug and a $15 copay for each covered brand name prescription drug.
Level 2B Income Limits Level 2B Out-of-Pocket Expenses

Income between 200% and 240% of the FPL

Individual: $25,521-$30,624
Couple: $34,481-$41,376

  • $850 deductible per person.
  • Pay the SeniorCare rate for covered drugs until the $850 deductible is met.
  • After $850 deductible is met, pay a $5 copay for each covered generic prescription drug and a $15 copay for each covered brand name prescription drug.
Level 3 Income Limits Level 3 Out-of-Pocket Expenses

Income more than 240% of the FPL

Individual: $30,625 or greater
Couple: $41,377 or greater

  • Pay retail price for covered drugs during spenddown.
  • After the spenddown is met, meet an $850 deductible per person.
  • Pay the SeniorCare rate for covered drugs until the $850 deductible is met.
  • After $850 deductible is met, pay a $5 co-pay for each covered generic prescription drug and a $15 co-pay for each covered brand name prescription drug.

These income limits are effective February 1, 2020. The amounts are based on the 2020 federal guidelines, which may change each year.

Last Revised: February 26, 2020