Extra Help for Medicare and Part D Drug Costs

Income limits for getting Medicare Part B premium help and extra help for drug costs have been increased for 2012. The federal poverty level is now set at $930.83 per month, so a person living on less than this amount qualifies for various assistance programs.  Additionally, people who live on up to 35% more than this amount can also qualify for some help through the Medicare Savings Program and the Low Income Subsidy for Part D.

MEDICARE SAVINGS PROGRAM income limits for getting help in 2012.  Add $20 to each amount below.

Qualified Medicare Beneficiaries (QMBs):  States must pay all Medicare cost-sharing for Medicare beneficiaries with incomes up to 100% of the federal poverty level (FPL) and limited resources.  For this group, the 2012 level is $930.83/month ($11,170/year) for an individual; $1,260.83/month ($15,130/year) for a couple.

Specified Low-Income Medicare Beneficiaries (SLMBs):  States must pay the Medicare Part B premium for Medicare beneficiaries with incomes between 100% FPL and 120% FPL and limited resources. The limit for this group is $1,117 /month ($13,404/year) for an individual; $1,513/month ($18,156/year) for a couple.

Qualified Individual (QI): States have a limited amount of money from which they must pay, on a first come, first served basis, the Medicare Part B premium for Medicare beneficiaries with incomes between 120% FPL and 135% FPL and limited resources.  The limit for this group is $1,256.63/month ($15,079.50/year) for an individual; $1,702.13/month ($20,425.50/year) for a couple.

EXTRA HELP FOR PART D:  Add $20 disregard to each amount.

Full Subsidy:  Medicare Part D provides a full drug subsidy with low co-payments to Medicare beneficiaries with incomes up to 135% FPL and limited resources.  For those individuals, the 2012 eligibility limit is $1,256.63/month ($15,079.50/year) for an individual; $1,702.13/month ($20,425.50/year) for a couple.

Partial Subsidy: Medicare Part D provides a partial subsidy of premium, deductible and co-insurance to Medicare beneficiaries with incomes up to 150% FPL and limited (but higher than allowed for full subsidy) resources.  The income limit for this group is $1,396.25/month ($16,755/year) for an individual; $1,891.25/month ($22,695/year) for a couple.

There is some confusion about how the recent increase in people’s Social Security benefits affects their QMB, SLMB, or QI status, and some people may have received letters in January telling them they now make too much money to get help. I talked to the AHCCCS Client Advocate’s office and was told people could lose their assistance until the income levels are officially raised on April 1. But I have talked to others outside the AHCCCS system who say people should not lose their help.  If anyone knows of people who have been dropped from QMB, SLMB, or QI-1, please contact me.

Arizona is one of just eight states that do not ask people about their assets, such as money in the bank or in retirement accounts, when reviewing an application for the Medicare Savings Program. Arizona only looks at a person’s income.

Call or email me if you have questions about getting help.

The income limit information was provided by The Center for Medicare Advocacy.

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2 Responses to "Extra Help for Medicare and Part D Drug Costs"

  1. carol says:

    I have a question if i might why is it you need so much information for a person to apply for medicare savings program i understand that there are things you have to ask but there seems to be some things that i cant see really has any thing to do with appling for this program. Now i understand that there are things you have to ask but it would be so much easer if any person who wants to apply could do it on line there are those of us that cant always get to a mail box or have a fax machine so why not setup an on line website so that anyone who would be interested in appling for the program would have access to a website that would allow a person to apply for the program. think about it. It would make things much easer for those of us who are disable and cant get around all that well. Just think how you would feel if you could not get around to well.

  2. Denise Early says:

    AHCCCS only asks for your income.  They don’t care about your assets.  Going through Social Security can result in a denial of help if a person has money in the bank or retirement funds.  So I usually recommend going through AHCCCS. Unfortunately, they don’t have an on-line application.

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