Extra Help for People on Medicare
by Bill Hunot, Social Security Administration
Some Missourians on Medicare now qualify for extra help-for free-with their
medical expenses This can save each of them hundreds-sometimes even
thousands-of dollars per year.
Medicare patients have a lot of out-of-pocket medical costs-even for
services that Medicare covers. The government doles out extra help with
those expenses based on the federal poverty line. That line just moved up,
and made more people eligible.
The oldest and most comprehensive of these programs is the Qualified
Medicare Benefit. QMB has been around since 1989.
Missouri's QMB program pays the monthly premiums for Part B of Medicare ($50
in 2001), and the monthly premiums for Part A of Medicare for people who
can't get it for free.
QMB also pays the $100 per year deductible that patients pay before Part B
starts to help with doctor bills and other out-patient costs. It pays 20
percent of some medical bills because Part B pays just 80 percent of those
bills. And it pays the $792 deductible patients pay when they're admitted to
the hospital, and the extra charges for long stays in the hospital.
QMB's monthly income limits are now $736 for a single person and
$988 for a couple.
The second-best program is the Specified Low-Income Medicare
Benefit. SLMB pays just the monthly Medicare Part B premiums-but that's a
savings of $600 per year. The monthly income limits for SLMB: $879 (single)
and $1,181 (couple).
Two other extra-help programs-for "Qualified Individuals"-help pay
Part B's premiums. They are relatively new, so many people are still unaware
of them. Funds for these programs are limited: Sign up ASAP because the
money could run out before everyone eligible applies.
QI-1 pays the whole Medicare Part B premium for singles whose
incomes are below $987 per month and for couples with income below $1,327
per month.
QI-2 pays part of the premium on a sliding scale (the higher the income, the
smaller the help) based on monthly income of $987 to $1,273 for a single
person, and $1327 to $1,714 for a couple.
Remember that none of these programs helps unless the applicant has
Medicare. And people on QMB, SLMB and QI must still pay for goods and
services-like prescription drugs-that Medicare doesn't cover.
The programs don't help either if the applicant has lots of assets or
"financial resources". The financial resource limits are $4,000 (for a
single person) or $6,000 (for a couple). Countable financial resources
include bank accounts, stocks, bonds and other property. Some assets-the
home, an automobile, burial plots, home furnishings, and insurance
policies-usually don't count.
Social Security offices cannot take applications for these programs-only the
local Medicaid office can do that. But don't confuse these programs with
Medicaid. Many people who are "too rich" for Medicaid still get extra help
with their Medicare premiums, deductibles and co-payments.
Call 1-800-392-2161 for the phone number of your local Medicaid office.
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