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2021-2022 Florida Medicare Savings Programs

Looking at Florida Medicare Savings Programs

The Florida Medicare Savings Program is a government-funded program that helps people pay their health insurance premiums. It also pays for other costs that depend on individual income. Cost-sharing includes out-of-pocket payments, self-financed benefits, and fixed payments for administering certain medications. The savings program helps with three different parts:

· Part A, which concerns inpatient hospital care.

· Part B includes outpatient services and visits to doctors.

· Part D, which covers the prescription drug plan. There are other parts of savings programs that private companies provide. They provide these services at a cost set by the government. The programs include:

A person who qualifies for Part A may qualify for the Medicare Savings Programs.

The eligibility criteria for Part A include:

· Seniors 65 and older.

· An individual receiving pension benefits

· People with disabilities

· Patients with terminal kidney disease

· Amyotrophic lateral sclerosis ALS patients.

· US Citizens / Legal Immigrants

Medicare savings programs have four levels, based on a person's income and resources:

· QMB - Qualified Medicare Beneficiary

· SLMB - Specific Low-income Medicare Beneficiary 

· QI - Qualified Individual Program

· QDWI - Qualified disabled and working Individuals

We'll look at all of those below in more detail.

Medicare Savings Program Florida Eligibility

Income and Resource Limits

Your eligibility for each program will depend on your income and available resources. Here are the resources that count toward your limits.

· Current checking account and savings account

· Bonds

· Stocks

· Investment funds

· Individual Retirement Account IRA

· Property

Some resources don't count when determining income and resource levels. They include:

· The main house and car

· Funeral plot and costs up to $1,500

· Furniture and household items

· Personal items

· Money held in your hand is not counted for nine months. Examples of holding money are tax advances and housing allowances.

QMB Program in Florida

This is a program that pays health premiums for people with limited income resources. It covers Part A and B premiums, out-of-pocket deductible expenses, co-insurance, and co-payment.

Who is eligible for QMB?

· A person who qualifies for Medicare Part A

· A Florida resident

· A US citizen or immigrant with residency status

· 2021 - An individual whose monthly income is less than $1,094, or $1,472 for couples

· 2021 - Assets of USD $7970 or less for an individual or USD $11,960 for a couple

How to apply for QMB Program in Florida

· The easiest way is to call us at 888-997-5204 and have us do it for you.

· You can otherwise visit the local Department of Child and Family Services DCF office. Most offices are currently closed due to covid.

· You can click here to get the Medicaid buy-in application.

Fill it in and send your application to DCF by email or fax.

What to do if you have QMB benefits, and the hospital charges you.

· Make sure your doctor knows you are in the program.

· Find out if your doctor accepts Medicare.

· Contact the Customer Relations Department if the billing persists.

· If you are not getting help, call your local Legal Aid to see if he/she can help.

SLMB Medicaid in Florida

SLMB is a government-funded program that helps low-income citizens pay for Part B premiums.

Who is eligible for SLMB?

· Those who qualify for the medical part A

· Those with limited monthly sources of income and resources. The state poverty level defines $1308 monthly income for singles and $1744 for the married. It also defines the asset limit as $7860 worth of singles' resources and $11,800 for couples.

What does Florida SLMB do for you?

· It pays Part B premiums.

· Automatic Extra Help (Low Income Subsidy for prescriptions).

How to Apply for SLMB

· The easiest way is to call us at 888-997-5204 and have us do it for you.

Or, the procedure is like the application process for QMB.

· Click here to get the Medicaid buy-in application.

Fill it in and send your application to DCF by email or fax.

QI (Qualified Individual Program)

This program helps state residents reduce payments for Part B premiums. When Clients apply for QI benefits, they receive them on a first-come-first-service basis. Those who received benefits in the previous year also come first.

Who is eligible for QI?

· Those with Part A coverage and those eligible for Part A

· Singles with a monthly income of $1,456 and couples $1,933

· Singles whose annual asset limit is $7,730 and couples with an $11,600 asset limit.

QI medical benefits

· Lower medical costs

· Automatic extra help

How to apply for QI in Florida

The application process is like the process in QMB above.  Or for the easiest way, call us at 888-997-5204 and we will help you.

QDWI (Qualified Disabled and Working Individuals)

It helps the working class living with disabilities and under 65 years old to pay their Part A premiums.

Who is eligible for QDWI?

A person who works under 65 and lives with a disability

Anyone Who has lost the non-contributory part A after resuming work

Anyone who does not receive medical help from the state

Any unmarried person with a monthly income of $4399 and $ 5333 for couples is eligible. An asset limit of USD 4000 for a single person and USD 6000 is also required.

Medical benefits of QDWI

Reduces the cost of inpatient services.

How to apply for QDWI

You can apply for this program by:

Visiting the Medicaid Office, or by calling the us at 888-997-5204.

QDWI is renewable every year. The local Medicaid office will send renewal notices by email, reminding recipients to renew.

Florida Extra Help Program (Low Income Subsidy)

This program is a government-funded program that reduces the cost of out-of-pocket prescription drugs. It is also known as a low-income subsidiary LIS. Extra help has two categories, full extra help, and partial help. Full help covers Individuals with monthly incomes equal to or less than $1,469 for singles and $1,980 for couples. Individuals earning $1,630 for singles and $2,198 for couples per month are eligible for partial help.

What does Extra Help cover?

It covers prescription costs, deductibles, and co-insurance.

Who is eligible for LIS?

· Single people whose monthly income is less than $1,630, and less than $2,198 for couples. They should also have a wealth limit of $14,790 or less for singles and $29,520 or less for couples.

· Members of a Medicaid supplemental insurance program or a health care savings program.

What Does Extra Help Get You?

· It Reduces the cost of prescription drugs.

· It Clears the penalty for Part D caused by late registration.

How to apply for Extra Help (LIS)

· Call us for help at 888-997-5204.

· Apply online at https://www.ssa.gov/extrahelp/.

· Call Social Security at 1-800-772-1213 or 1-800-325-0778

· Applications to a local office.

Social Security communicates through letters, informing the applicants of their qualifying status.