a. Qualified Medicare Must have Medicare Part A or apply for Medicaid pays recipient’s Medicare deductibles, co-insurance, Beneficiary (QMB) Part A and monthly premiums for Part B (and Part A if applicable) “conditional” Category 40 100% FPL Will pay Conditional Part A premium Monthly Income Limit Asset Limit Adds $96.40 to monthly Social Security check Note: Amounts go in affect No retroactive coverage, eligibility begins the month after the April 1 month approved Individual $951 $6,940 Receive a Medicaid card Couple $1,281 $10,410 Recertification required at least every 12 months (One $20 disregard per household is allowed before the Qualifies for LIS Medicare Part D no deductible, no monthly – federal guidelines premium, $1.10 - $6.30 co- pay for most medications . b. Specified Low Income Must have Medicare Part A Medicaid pays recipient’s Medicare Part B premium Medicare Beneficiary (SLIMB) Adds $96.40 to monthly Social Security check Category 45, 120% FPL Monthly Income Limit Asset Limit Eligibility begins the month of approval, 3 month retroactive coverage possible Note: Amounts go in affect Individual Will not pay Conditional Part A premium April 1 $1137 $6,940 Do NOT receive a Medicaid card Couple Qualifies for LIS Medicare Part D no deductible, no monthly – $ 1533 $10,410 premium, $1.10 - $6.30 co pay for most medications (One $20 disregard per household is allowed before the federal guidelines apply.) Qualified Individuals Must have Medicare Part A An expansion of the SLIMB program to those between 120% Category 045, 135 %FPL Monthly Income Limit Asset Limit and 135% of the federal poverty level Note: Amounts go in affect Medicaid pays recipient’s Medicare Part B premium April 1 Individual Adds $96.40 to monthly Social Security check $1277 $6940 Will not pay Conditional Part A premium Couple Eligibility begins the month of approval, 3 month retroactive $1723 $10,410 coverage possible (One $20 disregard per household is allowed before the Do NOT receive a Medicaid card federal guidelines apply.) Qualifies for LIS Medicare Part D no deductible, no monthly – premium, $1.10 - $6.30 co pay for most medications . 5. PUBLIC ASSISTANCE PROGRAMS
a. Qualified Medicare Beneficiary (QMB) Category 40 100% FPL Note: Amounts go in affect April 1 Must have Medicare Part A or apply for “conditional” Part A Monthly Income Limit Asset Limit Individual $951 $6,940 Couple $1,281 $10,410 (One $20 disregard per household is allowed before the federal guidelines . Medicaid pays recipient’s Medicare deductibles, co-insurance, and monthly premiums for Part B (and Part A if applicable) Will pay Conditional Part A premium Adds $96.40 to monthly Social Security check No retroactive coverage, eligibility begins the month after the month approved Receive a Medicaid card Recertification required at least every 12 months Qualifies for LIS Medicare Part D – no deductible, no monthly premium, $1.10 - $6.30 co- pay for most medications b. Specified Low Income Medicare Beneficiary (SLIMB) Category 45, 120% FPL Note: Amounts go in affect April 1 Must have Medicare Part A Monthly Income Limit Asset Limit Individual $1137 $6,940 Couple $ 1533 $10,410 (One $20 disregard per household is allowed before the federal guidelines apply.) Medicaid pays recipient’s Medicare Part B premium Adds $96.40 to monthly Social Security check Eligibility begins the month of approval, 3 month retroactive coverage possible Will not pay Conditional Part A premium Do NOT receive a Medicaid card Qualifies for LIS Medicare Part D – no deductible, no monthly premium, $1.10 - $6.30 co pay for most medications Qualified Individuals Category 045, 135 %FPL Note: Amounts go in affect April 1 Must have Medicare Part A Monthly Income Limit Asset Limit Individual $1277 $6940 Couple $1723 $10,410 (One $20 disregard per household is allowed before the federal guidelines apply.) . An expansion of the SLIMB program to those between 120% and 135% of the federal poverty level Medicaid pays recipient’s Medicare Part B premium Adds $96.40 to monthly Social Security check Will not pay Conditional Part A premium Eligibility begins the month of approval, 3 month retroactive coverage possible Do NOT receive a Medicaid card Qualifies for LIS Medicare Part D – no deductible, no monthly premium, $1.10 - $6.30 co pay for most medications 5. PUBLIC ASSISTANCE PROGRAMS