How new poverty guidelines can impact your health care costs
Last month, the U.S. Health and Human Services Department, released updates to their Federal Poverty Guidelines. The guidelines in this 2023 notice reflect the 8 percent increase between calendar years 2021 and 2022. After this inflation adjustment, the guidelines are rounded and adjusted to standardize the differences between family sizes.
For 2023, the poverty guideline in Kansas is $14,580 for a one-person family/household and $19,720 for a two-person family/household.
What does this mean for you?
The Federal Poverty Guidelines are a determining factor in Medicare and Medicaid eligibility. The 8 percent increase means some individuals and families who weren’t eligible for Medicare/Medicaid last year, will be eligible this year.
Health Care Costs
Some individuals who earned an income too high to qualify for reductions in their health care costs, may now qualify for sliding fee scale services.
For example, at Heartland Community Health Center, patients who fit income guidelines (≤ 200% Federal Poverty Level) are eligible for the sliding fee scale once they provide proof of income. This sliding fee scale is used to discount all out-of-pocket costs. So, in previous years if a single person had an annual income of $28,000, they would be ineligible for discounts. In 2023, that same person would now qualify for discounts.
Prescription Drug Savings
Certain pharmacies participate in the 340B Drug Pricing Program. This program helps pharmacies offer prescription drugs at more affordable prices to people who qualify. At River City Pharmacy for example, if a patient qualifies for the sliding fee scale, they can receive their medication at-cost!
Food, Childcare, Housing and More
The Federal Poverty Guidelines are used in determining eligibility for many assistance programs in Douglas, County. These programs are also likely to expand their coverage based on the lower income thresholds in the new guidelines. See below for links to more information.
- Food Assistance
- Temporary Assistance for Needy Families (TANF)
- Children’s Health Insurance Program (CHIP)
- Childcare Subsidy
- Women, Infants and Children (WIC) nutrition program
- Low Income Energy Assistance Program (LIEAP)
- Lawrence Douglas County Housing Authority
Confused about what health coverage you qualify for?
With so many different programs and requirements, navigating the health care system can be both overwhelming and confusing. Confusion about health insurance can cause some people to pay more for their coverage, delay medical care, or even avoid seeing a health care provider all together.
A Compass Project was created to help the public and Heartland patients navigate Medicaid eligibility assistance and education. In addition to Medicaid assistance, A Compass Project also helps with ACA Marketplace Enrollment, Crime Victims Medical Compensation, and Social Security Disability Claims.
Through the 340B pricing program, patients eligible for the sliding fee scale are able to receive medications from River City Pharmacy at-cost. New federal poverty guidelines give more Heartland patients access to these discounts on prescription drugs and reduced fees for medical care.