If you are eligible for Medicare (whether you are just turning 65 or are Medicare eligible because of a disability) and you have limited financial resources and income, you may be able to receive some financial assistance with your Medicare Part B premium payments and Medicare Part D cost-sharing payments - all through your state's Medicaid program.
One particular Medicare Savings Program is for the "Specified Low - Income Medicare Beneficiary" (or SLMB) and, according to the Centers for Medicare and Medicaid (CMS) SLMB is defined as:
"A Medicaid program that pays for Medicare Part B premiums for individuals who have Medicare Part A, a low monthly income, and limited resources." (source: Medicare.gov) In other words, the Medicaid program for Specified Low-Income Medicare Beneficiaries (or SLMB) pays only your Medicare Part B premium (and qualifies you for the Medicare Part D prescription drug plan financial Extra Help program).
Qualifying for SLMB status
If you have countable financial resources at or below two-times the standard allowed by the SSI program and an annual income not higher than 120% of the Federal Poverty Level (FPL), you may be qualified for your state's SLMB program and your state Medicaid program will pay your Medicare Part B premium.
Please note, the financial resource requirements and the Federal Poverty Level can change each year, so even if you did not qualify for the SLMB program last year, you may qualify this year. (Please also note that some states have more flexible or lenient income and assets levels for qualifying for their Medicaid programs - as noted by Medicare: "Limits are slightly higher in Alaska and Hawaii. If you have income from working, you may qualify for benefits even if your income is higher than the limits listed.").
For example, in 2011, the Individual monthly income limit for most states was: $1,109 ($1,491 for Married Couples). The financial resource level was $6,680 for individuals or $10,020 for married couples.
In 2012, the monthly income limits for most states were less than $1,137 for individuals or $1,533 combined monthly income for married applicants. The financial resource level (or liquid assets) may not exceed $6,940 for individuals or $10,410 for married couples.
A note on your financial resources:
[As noted by Medicare: "Countable resources include money in a checking or savings account, stocks, and bonds. When you count your resources, don’t include your home, one car, burial plot, up to $1,500 for burial expenses if you have put that money aside, furniture, or other household and personal items."] and ["If you have income from working, you may qualify for these benefits even if your income is higher than these limits. Many states figure your income and resources differently, so you may be eligible in your state even if you think you exceed these limits. Limits are slightly higher in Alaska and Hawaii. Some states have higher resource levels or don’t count resources. Check with your state to find out more"].
SLMB and Medicare Part D Extra Help
In addition, your SLMB status will also automatically qualify you for the Medicare Part D financial Extra Help program (or Low-Income Subsidy program).
The Medicare Part D Extra Help program will help you pay your Medicare Part D prescription drug plan premiums, provide lower co-payments on your medications, and remove the Donut Hole or Coverage Gap from your prescription drug coverage.
To learn more about the SLMB program, you may wish to contact your local Medicaid office and speak with a Medicaid representative about qualifying for the program or you can telephone the Social Security Administration at 1-800-772-1213 ( TTY users should call 1-800-325-0778..
You can click here (http://www.q1medicare.com/PartD-Financial-Assistance-by-Medicaid.php) to read more about the Medicare Part D Extra Help program and what qualifies for Income and financial resources.
What are the other types of Medicaid assistance?
Qualified Medicare Beneficiaries (or QMB)
The QMB program covers the payment of your Medicare Part B premium and the co-insurance(s) and deductibles you are required to make as part of the
Medicare program.
Example: Medicare Savings Program 2012 Income Limits - Qualified Medicare Beneficiary (QMB) Program
Individual monthly income limit - $951
Married couple monthly income limit - $1281
Qualified Individuals-1 (or QI-1) - The QI-1 program provides the same benefits as the SLMB program except that the income standards are higher than those allowed for SLMB.
Example: Medicare Savings Program 2012 Income Limits - Qualifying Individual (QI) Program
Individual monthly income limit - $1277
Married couple monthly income limit - $1723
Qualified Individuals-2 (or QI-2) - The QI-2 program reimburses you for a portion of the Part B premium that you have already paid which went toward home health care. You will receive a reimbursement check once a year. The income limits are higher than in QI-1.
Qualified Working Disabled Individual (or QWDI)
The QWDI program pays for your Medicare Part A premium only. QWDI can help you if you have lost eligibility for Title II disability benefits due to
earnings.
Example: Medicare Savings Program 2012 Income Limits - Qualified Disabled and Working Individuals (QDWI) Program
Individual monthly income limit - $3809
Married couple monthly income limit - $5129
(Please note the "2012 Example" financial limits are slightly higher in Alaska and Hawaii and if a person has income from working, they may qualify for benefits even if their income is higher than the limits listed.)
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