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UNOFFICIAL 1722-26

§17-1722-88 Application and eligibility determination for the LIS. Individuals may apply for the LIS and have their eligibility determined by the department by submitting an application on a form designated by the SSA upon request. [Eff 12/26/05 ] (Auth: HRS §346-14) (Imp: 42 C.F.R. §423.774; 423.904; Pub. L. 108-173)

§17-1722-89 Eligibility requirements. Individuals who are eligible for the LIS shall: (1) Have Medicare coverage; (2) Have income as evaluated under SSI regulations in 20 C.F.R. Part 416 Subparts K and L that does not exceed one hundred fifty

percent of the FPL for the family of applicable size; (3) Have resources as evaluated under SSI regulations in 20 C.F.R. Part 416 Subparts K and L that do not exceed the resource requirement under the MMA; (4) Be a resident of the State; (5) Not be an inmate of a public institution; and (6) Not be enrolled in PACE. [Eff 12/26/05 ] (Auth: HRS §346-14) (Imp: 42 C.F.R. §423.774; 423.904; Pub. L. 108-173)

§17-1722-90 Benefits of the LIS program. The LIS program provides full or partial assistance with the subsidy for the coverage of the monthly premiums and cost-sharing related to Medicare part D to individuals based on the countable income of their households:

(1) Full benefit dual eligible individuals with countable income up to one hundred percent of the FPL shall be responsible for:

(A) The portion of the premium that exceeds the low income benchmark premium amount for basic coverage; and

(B) Co-payments. (2) Full benefit dual eligible individuals above one hundred percent of the FPL, Medicare Savings Program beneficiaries, SSI recipients, and non-dual eligible