 |
Silver Tips
Remember “QMB” helps with Medicare's new drug coverage |
| Department home | Department contacts | Our A-Z Pages | Administrative Services | Adult Protective Services | Consumer and Elder Rights | Indian Elder Affairs | Links to related websites |
|
|
Silver Tips
Remember “QMB” helps with Medicare's new drug coverage |
|
Silver Tips is written by the Senior Citizens’ Law Office in Albuquerque.
The new Medicare prescription drug coverage will be much more affordable for Medicare beneficiaries who can get “QMB” (Qualified Medicare Beneficiaries) and similar New Mexico Medicaid coverages.
So it is important to renew efforts to get the word out, to as many Medicare beneficiaries as possible, as soon as possible, about the value of “QMB,” “SLIMB,” (Specified Low Income Medicare Beneficiary ) and “QI” (Qualified Individual)—the limited Medicaid coverages collectively known as the Medicare Savings Programs.
The Aging and Long Term Services Department and its partners have been active in publicizing and promoting the Medicare Savings Programs for years. Those programs are intended to help defray Medicare out-of-pocket costs for Medicare beneficiaries whose incomes and assets are limited, but not low enough to qualify for full-scope Medicaid. QMB pays for monthly Medicare premiums, deductibles and co-pays; SLIMB and QI just pay for the Medicare Part B premium. But the cost of Part B premiums alone is $938 in 2005 (it goes up every year), so beneficiaries save at least that much.
The new Medicare drug coverage provides an additional, extremely important reason for people who can qualify for a Medicare Savings Program to get the coverage. The reason is this: The new drug coverage will have substantial out-of-pocket costs, but Medicare beneficiaries who meet specified income and assets tests will get “extra help” that will cover most of those out-of-pocket costs. Beneficiaries who have QMB, SLIMB, or QI (as well as those with full-scope Medicaid) automatically qualify for the “extra help,” and will have only small drug coverage co-pays!
The income and assets maximums for the “extra help” are actually higher than those for QMB/SLIMB/QI; and beneficiaries are able to apply for just the “extra help” (that is the purpose of the multi-page applications that the Social Security Administration mailed out to 122,000 New Mexico Medicare beneficiaries this summer). But the QMB/SLIMB/QI application forms—which are filed with state Income Support Division (ISD) offices—are shorter and simpler. And successful applicants get both the QMB, SLIMB or QI benefit plus the “extra help.” We strongly encourage beneficiaries who may qualify for QMB, SLIMB, or QI to apply, and to do so as soon as possible (to get the “extra help” quicker).
Individuals with 2005 income less than $1,097 per month ($1,264 for couples), and assets less than $4,000 ($6,000 for couples) may qualify for QMB, SLIMB, or QI. Not all income and assets are counted (e.g., your home and a vehicle are not counted).
More information about QMB, SLIMB, and QI, the 2006 Medicare drug coverage, and the extra financial help, is available from various sources including the Aging & Long Term Services Department’s HIBAC (Health Insurance Benefits Assistance Counseling ) benefits counseling program (statewide, 1-800-432-2080; Bernalillo County residents can also call 265-1244). ISD office locations and numbers are printed in the government pages of your phone directory.
Abbreviations used in this article: HIBAC—Health Insurance Benefits Assistance Counseling QI—Qualified Individual QMB—Qualified Medicare Beneficiary SLIMB—Specified Low Income Medicare Beneficiary |