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 2021 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: $20,608
Couple: $27,872

  • 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: $20,609-$25,760
Couple: $27,873-$34,840
  • $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: $25,761-$30,912
Couple: $34,841-$41,808

  • $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: $30,913 or greater
Couple: $41,809 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, 2021. The amounts are based on federal guidelines, which may change each year.

Last Revised: February 1, 2021