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Help in Paying Medicare Out-of-Pocket Expenses for Some
Low-Income People
Medicare Savings for You
The Health Care Financing
Administration (HCFA), a Federal government agency that administers Medicare and Medicaid,
and your State have developed programs that can help pay your Medicare out-of-pocket
expenses. These programs help people who have limited resources and income to pay for some
Medicare expenses.
This could save you hundreds of dollars each year.
If you qualify, you may not have
to pay for your:
- Medicare premiums, and in some cases, deductibles, and coinsurance.
Several Programs Offer Help
There are four programs that offer different levels of help. They are:
- Qualified Medicare Beneficiary (QMB)
- Specified Low-income Medicare Beneficiary (SLMB)
- Qualifying Individual-1 (QI-1)
- Qualifying Individual-2 (QI-2)
You may qualify for one of these programs if:
1. You are entitled to Medicare Part
A. If you do not have Part A or you are not sure, check your Medicare card or call the
Social Security office on 1-800-772-1213 to find out how to get it.
2. Your financial resources, such as
bank accounts, stocks, and bonds, are not more than $4,000 for one person or $6,000 for a
couple. Some things - like the home you live in, one automobile, burial plots, home
furnishings, personal jewelry, and life insurance - usually do not count as resources. (If
the combined face value of the life insurance policy is less than $1,500, it is not
counted.)
3. Your monthly income is at or
below a certain level. Income includes Social Security benefits, pensions, and wages as
well as interest payments and dividends on stocks and bonds you may own. The amount of
help you can get depends upon your monthly income. The monthly income limits for different
levels of help are shown below. If your monthly income changes you may move to a different
level of help.
To qualify for any of the programs
listed below, you must meet requirements (1) and (2) listed above.
| If your monthly income in
1998 is at or below: |
You may qualify for: |
All States except Alaska
and Hawaii:
$691 (individual) $925 (couple)
Alaska: $860 (individual) $1,151 (couple)
Hawaii: $792 (individual) $1,060 (couple) |
Qualified Medicare
Beneficiary (QMB). This program pays your Medicare premiums, deductibles, and
coinsurance. |
All States except Alaska
and Hawaii:
$825 (individual) $1,105 (couple)
Alaska: $1,027 (individual) $1,377 (couple)
Hawaii: $946 (individual) $1,268 (couple) |
Specified Low-income
Medicare Beneficiary (SLMB). This program pays your Medicare Part B premium. |
All States except Alaska
and Hawaii:
$926 (individual) $1,241 (couple)
Alaska: $1,153 (individual) $1,547 (couple)
Hawaii: $1,062 (individual) $1,424 (couple) |
Qualifying Individual-1
(QI-1). This program pays your Medicare Part B premium. |
All States except Alaska
and Hawaii:
$1,194 (individual) $1,603 (couple)
Alaska: $1,489 (individual) $1,999 (couple)
Hawaii: $1,371 (individual) $1,840 (couple) |
Qualifying Individual-2
(QI-2). This program pays for a small part of your Medicare Part B premium. |
How Do I Apply for These Programs?
if you think you qualify, you should do the following:
- Contact your State, county, or local medical assistance
office. In some States, it could be your local social services office or your local Agency
on Aging.
- When you call, ask for information on programs that help
pay your Medicare Part B premium or ask how you can get help paying for some of your
Medicare expenses.
- Ask for an application.
- Ask what documents you will need.
- Ask if you must apply in person or if you can do it by
phone or mail.
- Complete and return the application with necessary
documents.
What Documents Do I Need to Apply?
You may often need the following documents when you apply,
but it is best to call your State to find out exactly what you will need. Gather these
documents BEFORE your first meeting or visit with your
State, county, or local medical assistance office and take them with you to avoid making
more than one visit.
- Proof that you have Medicare Part A
- Recent bank statements
- Property deeds
- Insurance policies
- Financial statements from any stocks or bonds you may own
- Proof of any funeral or burial policies you may have
- Proof of identity
- Proof of residence
- Proof of any income pension check, social security
payment, etc.
Where Do I Get More Information About These Programs?
For more information about these programs, call your State,
county, or local medical assistance office. Check your phone directory for the office
nearest you. You can find these offices listed under Medicaid, Social Services, Medical
Assistance, Public Assistance, Human Services or Community Services or call 1-800-638-6833
to speak to a representative from HCFA that will help you in finding the phone number in
your State.
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