Arizona has three Medicare Savings Plans (aka: Medicare Cost Sharing plans): QMB, SLMB, and QI-1.
The Qualified Medicare Beneficiary or QMB program pays for Medicare Part A and B premiums, co-insurance (that is the 20% that Medicare doesn’t pay of the Medicare assignment amount), and the annual Medicare deductibles. The 2017 monthly income limit for the program is $1,005.00 per month for a single individual and $1,354.00 for a married couple. Those that have Medicare only and apply and qualify for QMB can continue to use any doctor or hospital they choose – they do not have to switch to AHCCCS/Medicaid approved providers. However, those who want can also enroll with an AHCCCS health plan to receive full AHCCCS/Medicaid medical benefits and QMB benefits.
The second and third Medicare Savings Plan programs have higher income limits but less overall benefits. These two programs pay for the monthly Medicare Part B premium only. These programs are called SLMB and QI-1.
The SLMB monthly income limit range is $1,005.01 to $1,206.00 for a single individual and $1,354.01 to $1,624.00 for a married couple.
The QI-1 monthly income limit range is $1,206.01 to $1,357.00 for a single individual and $1,624.01 to $1,827.00 for a married couple.
There is a $20.00 deduction from your total gross monthly income to determine if you qualify. So, if your gross monthly income (that’s the amount you get before anything is deducted from your income) is just up to $20.00 over the limits stated, you still may qualify for one of these benefits. Also, any interest or dividends received from investments or savings DO NOT count against the total gross monthly income limits stated AND there are no asset or resource guidelines that must be met to qualify for these benefits.
If you qualify for one of the Medicare Savings Plans, you are automatically eligible for the LIS program, too!
The LIS (Low Income Subsidy or Extra Help) program also increased its limits. The LIS monthly income limit range is $1,357.01 to ~$1,507.00 for a single individual and $1,827.01 to ~$2,030.00 for a married couple. This program does have a resource (asset) limit. The resource limit range is $8,890.00 to $13,820.00 for a single individual and $14,090.00 to $27,600.00 for a married couple. This program subsidizes one’s Medicare Part D (prescription drug plan) premium and co-pays.
Visit AHCCCS’ website to access the application for the Medicare Savings Plan programs.
Visit Medicare’s website to access the application for the Low Income Subsidy / Extra Help program.
Article written by Carol Aragon-Montgomery 05/25/17