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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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Senior Answers and Services and Colorado Gerontological Society are not for profit organizations dedicated to education and the dissemination of information pertinent to seniors and professionals in the field of aging. Correspondence or questions regarding the information on this site should be forwarded to:

Eileen Doherty M.S., Executive Director
3006 East Colfax, Denver, CO  80206 *  303.333.3482 ** 303.333.9112 (fax)