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State and Federal Assistance

State and Federal Assistance

There is financial extra help available to Medicare beneficiaries who have limited income and resources that pays for some health care and prescription drug costs. Depending on your income and resources, you might qualify for one or more of the following six programs:

To learn more about these programs or help in applying and the qualifications please contact one of our enrollment specialist.

Extra Help / Low-Income Subsidy (LIS)

The Medicare Part D Extra Help or Low-Income Subsidy (LIS) is a national federal program that helps people with limited financial resources pay for their Medicare Part D prescription drug coverage. For more information, you can read below and see Extra help paying for Medicare prescription drug coverage If you receive Medicare Part D Extra Help, you may pay a lower or no monthly premium, a lower or no initial deductible, have coverage in the Donut Hole or Coverage Gap, and pay very little for your prescription drugs that are covered by your Medicare Part D plan. If you qualify for Medicaid, you automatically qualify for the Medicare Part D "Extra Help" program that may lower the cost of your prescription drugs.

2017 Income limits to qualify for Extra Help

Individuals $18,090 annual income ($1507.50 monthly) Resources up to $13,820

Married Couple $24,360 annual income ( $2030 monthly) Resources up to $27,600

Resources are assets with include money in checking, savings, and bank accounts, 401k, stocks, bonds Resources do not include your house or one car, burial plot, up to $1500 in burial expenses if you have it put aside, furniture, and other household items.

Medicaid

Medicaid covers 69 Million people. It is the nation's public health insurance program for low-income children, adults, seniors, and people with disabilities, covers 1 in 5 Americans, including many with complex and costly needs for medical care and long- term services. Most people covered by Medicaid would be uninsured or underinsured without it. The Affordable Care Act (ACA) expanded Medicaid to reach low-income adults previously excluded from the program and provided federal funding to states for the vast majority of the cost of newly eligible adults. Income and asset limits vary by state.

How to apply for Medicaid?

Contact your local states Medicaid office. Look up state office

Contact one of our enrollment specialist in your area.

Nearly two-thirds of Medicaid spending is For the elderly and people with disabilities, FY 204

Medicare Savings Programs

Eligibility Guidelines

To qualify for Medicare Savings Programs, you must meet your state's income and asset guidelines. Listed below are the baseline federal income and asset limits for an MSP. Most states use these limits, but some states have more generous income and/or asset guidelines. For example, Alaska, Connecticut, the District of Columbia (DC), Hawaii, and Maine have higher income limits. Alabama, Arizona, Connecticut, Delaware, DC, Mississippi, New York, and Vermont do not apply asset limits.

2017 Medicare Saving Program Eligibility Standards:

Qualified Medicare Beneficiary (QMB):

Monthly Income Limits: (100% Federal Poverty Level or FPL + $20)
Most States: $1,025 – Individual or  $1,374 – Couple
Asset Limits: $7,390 – Individual  or $11,090 – Couple

Specified Low-Income Medicare Beneficiary (SLMB):

Monthly Income Limits: (120% FPL + $20)
Most States: $1,226 – Individual or $1,644 – Couple
Asset Limits: $7,390 – Individual or $11,090 – Couple

Qualifying Individual (QI):

Monthly Income Limits: (135% FPL + $20)
Most States: $1,377 – Individual  or $1,847 – Couple
Asset Limits: $7,390 – Individual or $11,090 – Couple

Income limits, which are based on the FPL, generally increase each year. New limits take effect on January 1 and are released in January or February. The amounts listed above include a standard $20 income disregard. Your state may disregard other income as well. Double-check with your state for current income guidelines and to find out which income will and will not be counted.

Financial resources or assets cannot include your primary home or your primary car. Other types of assets may not count. Check with your local Medicaid office for exact eligibility rules.

See the reverse side of this page for more information on income and asset disregards.

Income and Asset Disregards

Even if your income (money you take in, for example, Social Security payments that you get or wages that your earn) or assets (resources such as checking accounts, stocks and some property) are higher than the guidelines in your state, you should still apply. This is because certain kinds of income and assets may not be counted. Under federal law, states cannot count certain kinds of income and assets.

Some examples of income that will never be counted are:

  • The first $20 of your monthly income;
  • The first $65 of monthly wages;
  • One-half of your monthly wages (after the $65 is deducted); Food stamps.

Some states exclude more of your monthly income than the examples listed above.

In all states, the following assets will never be counted:

Your primary house;

  • Your car;
  • Household goods and wedding/engagement rings;
  • Burial spaces;
  • Burials funds for you and your spouse valued up to $1,500 each; •Life insurance with a cash value of less than $1,500.

Supplemental Security Income Benefits

Supplemental Security Income (SSI) is a monthly benefit paid by Social Security to people with limited income and resources who are disabled, blind, or age 65 or older. SSI benefits provide cash to meet basic needs for food, clothing, and shelter. SSI benefits aren't the same as Social Security benefits. You can make an appointment to apply for SSI benefits on the telephone or in person at your local Social Security office.

Who qualifies for this program?

To qualify for SSI, you must have limited income and resources, and be disabled, blind, or age 65 or older. You also must be a resident of the U.S., not be absent from the country for more than 30 days, and be either a U.S. citizen or national, or in one of certain categories of eligible non - citizens. People who live in Puerto Rico, the Virgin Islands, Guam, and American Samoa generally can't get SSI benefits.

How do I apply for this program?

Call Social Security at 1-800-772-1213, or contact your local Social Security office for more information. TTY users should call 1-800-325-0778. You can also visit www.socialsecurity.gov and use the "Benefits Eligibility Screening Tool" to find out if you are eligible for SSI or other benefits to help you decide whether to apply.

PACE (Programs of All-inclusive Care for the Elderly)

PACE combines medical, social, and Long-term Care services for frail elderly people who live in and get health care in the community. PACE programs provide all Medically Necessary services, including prescription drugs. PACE is a joint Medicare andMedicaid program that may be available in states that have chosen it as an optional Medicaid benefit. PACE might be a better choice for you instead of getting care through a nursing home. PACE is available only in states that have chosen to offer it under Medicaid.

Who qualifies for this program?

The qualifications for PACE vary from state to state.

How do I apply for this program?

Call your State Medical Assistance (Medicaid) office to find out if you are eligible and if a PACE site is near you. For more information, see 1-800-MEDICARE Helpline. You can also visit www.cms.hhs.gov/pace/pacesite.asp on the web for PACE locations and telephone numbers.

Programs for People who live in the U.S. Territories of Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa

There are programs to help people with limited income and resources pay their Medicare costs. These programs are available in Puerto Rico, the Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa.

Who qualifies and how do I apply?

Programs vary in these areas. Call your State Medicaid office to find out more about their rules. Visit www.medicare.gov on the web or, call 1-800-MEDICARE (1-800-633-4227) for more information. TTY users should call 1-877-486-2048.