What is Medicare?
To qualify for Medicare, an individual must:
- Be at least 65 years of age; or
- Have been eligible for some sort of Social Security Disability(SSD) payment for 24 months or more.
What does Medicare Cover?
There are several parts to Medicare:
Part A- Hospital insurance.
Part B- Health insurance for doctors visits, durable medical equipment, etc.
Part C- Optional component to Medicare also known as a Medicare advantage plan. These are private companies approved by Medicare that provide both part A and B coverage, but may also provide additional coverage not provided under "traditional" Medicare such as dental services.
Part D- Prescription Drug coverage
Part A Medicare is free of change (for most) and automatic when someone becomes Medicare eligible. Individuals who have not paid enough into Medicare over their working career will have a premium, but this is a very small group.
Part B carries a monthly premium of $104.90 per month as of January 2015. This premium is typically deducted from an individual's SSD cash benefit if they receive one.
Parts C and D premiums vary depending on the plan.
Medicare Savings Programs
Qualified Medicare Beneficiary (QMB) program can pay part A premiums and deductibles and part B monthly premiums for individuals that do not have monthly income exceeding $1,011 or assets exceeding 7,280. The asset limit is as of January 2015.
Special Low-Income Medicare Beneficiary (SLMB) program can pay part B premiums for individuals with income no higher than $1,197 per month or assets exceeding $7,280. The asset limit is as of January 2015.
Application and Eligibility for Medicare Savings Programs
Applications for the Medicare savings programs are processed by local Departments of Social Services. When DSS looks at eligibility, the following is excluded:
- The first $20 of unearned income
- The first $65 of earned income ($85 if no other income)
- One half of the remaining earned income
- Value of an individual's home
- Home furnishings
- Burial Plots
- Value of one vehicle
Medicare Part D Low Income Subsidy
The low income subsidy program can pay Medicare part-D monthly premiums and co-payments for individuals with limited income and resources. A helpful screening tool can be found at: https://secure.ssa.gov/i1020/start.
This article was contributed by Michael Klinger, Work Incentives Specialist for the Virginia Department of Rehabilitative Services. For more information or any other benefits related questions, contact Michael Klinger at 434-298-7652 or Michael.firstname.lastname@example.org.