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More Seniors May Be Eligible for Assistance with Medicare Costs
by Eileen Doherty, Executive Director
Senior Answers and Service
and the Colorado Gerontological Society
Low income Medicare beneficiaries will have more opportunities in 2010 to receive assistance with
prescription drug costs as well as payment for the Medicare Part B payments. This can total more than $1150 per year in savings.
Hundreds more people will benefit from the changes in the amounts of the resources limits and elimination of life insurance policies
as a resource to qualify for extra help to pay for prescription drug costs.
Both the prescription drug assistance program better known as the Low Income Subsidy (LIS) or Extra Help
and the Medicare Savings Program (MSP) which provides assistance with payments for Medicare Part B premium and for some low income people,
help with deductibles and co-payments are affected by these changes.
The LIS program pays for premiums, deductibles, co-payments, and help through the coverage gap for
prescription drug coverage for eligible individuals.
Starting January 1, 2010 individuals applying for the LIS program for prescription drugs must
have less than $16,245/year ($21,855/year for a couple) and $12,510 in resources plus a funeral allowance for $1500 ($25,101/year for
a couple plus a funeral allowance of $3000). The cash value of life insurance policies will no longer be counted as a resource. In
addition, individuals living with family members will no longer be penalized if someone else pays for household expenses such as food,
mortgage, rent, heating fuel or gas, electricity, water and property taxes.
In addition, due to changes in resource requirements, more individuals will be eligible
for the MSP. There are three programs within the MSP, namely the Qualified Medicare Benefit Program (QMB), Special Low Income
Medicare Benefit (SLIMB), and Qualified Individual Program (QI-1).
The QMB program pays for the Medicare Part B premium of $96.40/month, the co-payments and the
deductibles for Medicare Part A and B. The SLIMB and QI-1 program pays for the Medicare Part B premium, only.
The income requirements for the QMB Program are $903/month ($1214 for a couple).
The income requirements for the SLIMB Program are $1083/month ($1457 for a couple) and for the QI-1 Program are $1218/month ($1639
for a couple). Starting in January 2010, the countable resource requirements for the QMB program will be $8,100 for an individual
and $ $12,910 (couple) for a couple.
Beginning in January 1, 2010, states are prohibited from recovering Medicaid expenditures
for Medicare premiums and cost-sharing paid under MSPs from the estates of deceased Medicaid/MSP recipients. Concern over this
provision has many people from taking advantage of these programs.
Starting January 1, 2010, individuals who enroll in either the MSP or LIS will
automatically be enrolled in the other program. Individuals who have enrolled in the LIS program and are automatically enrolled in
the MSP will receive information from the county department of human services to provide verification for income, resources,
citizenship and identity.
The income requirements for these programs may change in March 2010. Individuals who are
not currently eligible should have their circumstances reviewed for possible eligibility later in 2010.
Individuals needing help with eligibility, enrollment questions, verification
requirements or other assistance, can all 303-333-3482.
Eileen Doherty, MS is the Executive
Director of Senior Answers and Services and the Colorado Gerontological
Society, 3006 East Colfax, Denver CO 80206. She has more than 30 years of
experience in education and training, clinical practice, research, and public
policy in gerontology. You may reach her at 303-333-3482 or Doherty001@att.net
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