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What Are The Medicare Savings Programs?
They are Medical Assistance (MA) benefit programs to assist you in paying
Medicare premiums, deductible, and coinsurance if you have limited income
and resources.
Must I Be Eligible for MA to Receive These Benefits?
No, you are allowed to have higher income and resources than is allowed
under the Medical Assistance program.
What Do These Programs Pay For?
- Medicare premiums
- Medicare deductibles
- Medicare coinsurance
How Do I Qualify for These Benefits?
- You must be entitled to receive Medicare Part
A ("entitled" means you are eligible for Part A benefits even if you
do not receive them).
- Have countable resources which do not exceed
$4,000 for an individual or $6,000 for a couple.
- Have countable monthly income (after certain
deductions) of less than:
| Program |
Individual |
Couple |
| QMB |
$ 867 |
$1167 |
| SLMB |
$ 1040 |
$1400 |
| QI-1 |
$ 1170 |
$1575 |
What Resources are Exempt or Not Counted?
- A residence occupied by you, your spouse, or your dependent relative.
- One motor vehicle, household goods and personal effects.
- Property which is essential to earning a livelihood, property essential
to self support, and property up for sale, but not sold.
- Indian trust land, per capita and judgment funds.
- Any prepayments or deposits totaling $5,000 or less, plus interest
accruing after July 1, 1989, designated for a burial. Also a burial
plot for each family member.
OR
- A burial fund up to $1,500 plus interest accruing after July 1, 1989,
each for you and your spouse. Also a burial space for you, your spouse
and immediate family members.
- Life or burial insurance with a cash value if the face value of all
such policies total $1,500 or less.
- The face value of all life or burial insurance policies will
be considered toward the $1,500 burial fund exclusion. (This exclusion
is not allowed if you choose the $5,000 burial option.)
Lump sum payments of Social Security Disability Insurance (SSDI) or Supplemental
Security Income (SSI) benefits are excluded for nine (9) consecutive months
following the month you receive them.
Where Do I Apply for the Programs?
Contact your local County Social Service Office for an application.
You have the right to complete an application.
What If I am Denied?
You can appeal. The appeal is a request for a hearing and must be in
writing. You have 30 days from the date of the notice to appeal.
Disclaimer: This information is not legal advice. If you have a legal problem, you should talk to a lawyer and ask for advice about your options.
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