Families USA has released a report which indicated that between 303 and 309 million low income seniors and disabled individuals who receive social security benefits are not receiving all the benefits they are entitled to. Here in Minnesota the organization estimates there are between 36,000 and 46,000 low income seniors and people with disabilities who may be affected.
Each month, the Social Security Administration deducts the cost of Medicare premiums from recipients' social security checks, but many low income seniors and people with disabilities are eligible to have their Medicare premiums paid by federal programs enacted by Congress. This deduction is currently $50.00 per month, or $600.00 annually for single people. For couples, the cost is $1,200.00 annually.
There are several federal programs to help low income seniors and disabled individuals pay for their medical costs, called Medicare Buy-In programs. These programs were designed to protect low income beneficiaries from the extreme hardships created by Medicare cost-sharing requirements. Under these programs, the federal government provides financial assistance to help defray the costs for certain health-care expenses. Each of these programs has a standard $20 income disregard (included in amounts given).
Qualified Medicare Beneficiaries (QMB's) are seniors and people with disabilities who receive social security benefits, and have an annual income at or below the poverty level (currently $9,310 annually, or $776 per month for single people; $12,490 annually, or $1,041 per month for couples). People in this category are eligible for financial assistance covering their Medicare premiums, deductibles, and co-payments.
Specified Low-Income Medicare Beneficiaries (SLMB's) (sometimes also called Service Limited Medicare Beneficiaries) are seniors and people with disabilities whose incomes are between 100 and 120 percent of poverty ($11,172 annually or $931 per month for single people; $14,988 annually or $1,249 per month for couples). People in this category are eligible for assistance with their Medicare Part B premiums only. (Those eligible for QMB or SLMB may also be eligible for the Minnesota Prescription Drug Program - which has similar income and asset guidlines)
Qualified Individuals - Group 1 (QI-1's): Seniors and people with disabilities whose incomes are between 120 and 135 percent of poverty ($12,576 annually or $1,048 per month for single people; $16,872 annually or $1,406 per month for couples) are eligible through a block grant program to apply for payment of their Medicare Part B premiums. This block grant program serves potentially eligible persons on a first-come first-served basis. Due to limited funds in the block grant, the government estimates that only a portion of those who are eligible to apply for the benefit will actually receive it. However, as of June 1998, only 4,723 individuals were enrolled in the QI-1 program - less than one percent of the estimated 499,000 people who could potentially be served by this program.
Qualified Individuals - Group 2 (QI-2's) are seniors and people with disabilities whose incomes are between 135 and 175 percent of the poverty level (up to $16,296 annually or $1,358 per month for single people; $21,864 annually or $1,822 per month for couples). People in this category are eligible to receive partial payment of the Medicare Part B premiums. In 2001, this program paid $3.09 per month, up to a total of $37.08 for the year.
For all four categories, the resource limit for eligibility is $10,000 for an individual and
$18,000 for couples.
Guidelines effective for year 2004.
Many people are unaware of the Medicare Buy-In program. Medicare beneficiaries must visit a Social Security office to enroll in Medicare, but can not apply for buy-in benefits at the same office. Instead, they must make a separate trip to the county Department of Social Services.
If you think you are eligible for one of these programs, you should contact your county's Department of Human Services. You can also contact the Minnesota Department of Human Services, at 1-800-657-3739, or the Medicare Hotline at 1-800-638-6833 for the number of the Insurance Counseling and Assistance Program nearest you.
This information is provided by Southern Minnesota Regional Legal Services which provides free advice and representation to low income individuals and senior citizens. It is not meant to be a complete answer to an individual legal problem. If you need legal help, see your family attorney, or contact Southern Minnesota Regional Legal Services at 66 East Third Street, PO Box 1266, Winona, Minnesota 55987-7266; telephone (507) 454-6660, or toll-free 1-888-575-2954.
More information about Medicare can be found through our Links page.