Do Medicare assets affect a person's coverage in any way?

1 answer | Last updated: Nov 23, 2013
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Caring.com User - Joseph L.  Matthews
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Joseph L. Matthews is a Caring.com Expert, an attorney, and the author of Long-Term Care: How to Plan & Pay for It and...
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Persons may be eligible for any of the four parts of Medicareregardless of how much they have in income or assets. The only thing about Medicare that income and See also:
Is there help for someone under age 65, who has serious illness and little money?
assets might affect is how much a person pays for a particular part of Medicare coverage.

High income may mean a higher Part B premium. Everyone enrolled in Medicare Part B pays a monthly premium for it. In 2009, the basic premium is $96.40 per month. But a single person (or married but filing a separate tax return) with an adjusted gross income over $85,000 per year, or a couple whose combined yearly adjusted gross income is over $170,000, pays a higher premium for Part B, as follows:

  • Up to $107,000 (single person)/$214,000 (couple) income, the Medicare Part B premium is $134.90 per person, per month.
  • Over $107,000/$214,000 and up to $160,000/$320,000 (single/couple), the Medicare Part B monthly premium is $192.70 per person.
  • Over $160,000/$320,000 and up to $213,000/$426,000 (single/couple), the monthly Medicare Part B premium is $250.50 per person.
  • Over $213,000/$426,000 (single/couple), the monthly Medicare Part B premium is $308.30 per person.
  • Medicare bases these calculations on tax returns from the two previous years. If a Medicare enrollee's actual income has dropped over those years, he or she can provide Medicare with this information and request an adjustment of the premium.

Low income and few assets may mean help paying Medicare premiums, deductibles, coinsurance amounts, and co-payments. If a person's income and assets are low enough to qualify for Medicaid, Medicaid will pay the monthly premiums for Medicare Part B and for a Medicare Part D prescription drug plan, and it will help pay for Medicare Part D prescription drug co-payments. Medicaid will also pay the Medicare Part A hospital inpatient deductible and coinsurance amounts, as well as Medicare Part B monthly premiums and coinsurance amounts.

Even if a person's income or assets are slightly too high to qualify for Medicaid, he or she might still qualify for other government programs that help pay for some Medicare costs. The Qualified Medicare Beneficiary (QMB) program pays all of a qualifying person's Medicare Part A and Medicare Part B premiums, deductibles, and coinsurance. If someone's income or assets are slightly too high to qualify as a QMB, he or she might still qualify as a Specified Low-Income Medicare Beneficiary (SLMB) or a Qualifying Individual (QI). These programs pay all or part of a person's Medicare Part B monthly premiums but do not pay any Medicare deductibles or coinsurance amounts.

To apply for the Medicaid, QMB, SLMB, or QI program, contact your local state Medicaid office. You can find your local office by going online to any search engine and entering Medicaid and the name of your state. Or you can call the Eldercare Locator toll-free at (800) 677-1116 and ask for contact information for your local Medicaid office.

 

 
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