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Health Insurance/ Medicare
& Medicaid
Medicare Savings Programs help people with Medicare pay for health care costs
“Medicare Savings Programs” is the new name for four Medicaid programs (originally called
QMB, SLMB, Ql-1 and Ql-2) that can save money for people on Medicare who don’t have much income and resources. The information below describes the benefits available from Medicare Savings Programs, and outlines who is eligible.
Even though these programs are called Medicare Savings Programs, they are actually Medicaid programs. People who believe they might be eligible can apply by contacting their local Department of Social Services to request an application for Medicaid.
QMB pays the Medicare Part B premium ($50 per month in 2001). When someone qualifies for
QMB, his or her Social Security check will increase by $50 per month (during 2001). That’s only the beginning of the savings.
QMB also pays the Medicare Part A and Part B deductibles and co-payments. The Part B deductible is the first $100 per year paid for doctor services. The Part B co-payment is your 20% share of the charges covered under Part B (for doctors’ services; out-patient hospital services; lab tests, x-rays, etc.). The Part A deductible is the $792 you pay for a hospital stay. The Part A co-payments are charged for a lengthy hospital stay (more than 60 days), or for a stay of more than 20 days in a skilled nursing facility.
QMB coverage is so helpful, that most people who have QMB don’t need a Medicare supplement policy. One thing QMB doesn’t cover is prescription drugs. But the money you save with QMB coverage can help pay for prescriptions.
Note: To take advantage of QMB coverage of Medicare
deductibles and co-payments, people with QMB would have to
see doctors who accept Medicaid.
People whose income is too high for QMB might still qualify for help with the cost of the Part B premium. Both SLMB and Ql-1 pay the Medicare Part B premium. If you apply and are found eligible for SLMB or Ql-1, Medicaid will pay the Medicare premium. Your Social Security check will increase by the amount of the Part B premium ($50 in 2001).
Why are there two Medicaid programs (SLMB and Ql-1) that both pay the Medicare Part B premium?
The difference between SLMB and Ql-1 is that Ql-1 is paid from a limited fund of money, on a first come, first served basis. Each year, it’s possible that Ql-1 funds might run out. If that should happen, Ql-1 benefits would stop.
Ql-2 only pays $3.09 toward the monthly Medicare Part B premium. Like Ql-1, Ql-2 is paid from a limited fund of money, on a first come, first served basis. Funds for the Q-l programs are available only through 2002.
WHO IS ELIGIBLE for The Medicare Savings Programs?
- You must be enrolled in Medicare Part A (hospital insurance).
- For a single individual, financial resources (such as bank account, certificates of deposit, stocks and bonds) must be less than $4,000. For a married couple, financial resources must be less than $6,000. (Your home, one car, and ordinary household and personal belongings are not counted as resources.
Your total monthly income (from Social Security, pensions, wages and other sources) must be less than the levels shown below.
Medicare Savings Programs
Figures shown are for the year 2000.
Year
2000
Monthly Income Limits |
What the Program Pays |
Program Name |
$716 for an individual
$958 for a couple |
Medicare
premiums, Deductibles, and Co-insurance |
Qualified
Medicare Beneficiary (QMB) (also known as “Quimby”) |
| $855 for an
individual $1,145 for a couple |
Medicare Part B premium ($50 per month in 2001) |
Special (or
specified) Low-Income Medicare Beneficiary (SLMB) (also known as “Slimby”) |
| $960 for an
individual $1,286 for a couple |
Medicare Part B premium($50 per month in 2001) |
Qualifying Individual – 1(Ql-1) |
$1,238 for an
individual
$1,661 for a couple |
$3.09 per
month toward the Medicare Part B premium |
Qualifying Individual – 2(Ql-2) |
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Insurance/Medicare & Medicaid
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