A University of Alabama Law School Clinical Program funded in part by West Alabama Regional Commission

Help With Premiums And Other Costs

Medicare Savings Programs

The Alabama Medicaid Agency pays the Part B premiums for certain beneficiaries with low incomes. The first two programs are mandatory; the third depends on availability of state funds, which sometimes run out before the end of a year.

Qualified Medicare Beneficiary (QMB); Monthly income limit for individuals is $923, for couples, $1,235 (in 2009). In Alabama there is no resource limit, and income from resources is not considered. QMB pays the Part B premium and also the Part A and Part B deductibles. The Agency will arrange for there to be no copayments, but only if providers participate in Medicaid. (Many doctors will not accept Medicaid.) QMB also pays the Part A premium for those few individuals who are required to pay a premium.

Specified Limited Medicare Beneficiary (SLMB) pays the Part B premium only. In 2009 the individual income limit is $1,103 monthly, for couples it is $1,477.

Qualified Individual-1 (QI-1) pays the Part B premium only. 2009 income limit for individuals is $1,239, for couples $ 1,660,because of the state's current financial distress. However, no applications are being taken for QI-1. The status for 2010 is unclear.

There is also a program of assistance for Qualified Working Disabled Individuals (QWDIs), whereby an individual working for a limited salary that would otherwise disqualify him or her from help may receive assistance. Potential recipients should contact SSA.

Although Alabama does not consider either resources or income from resources, in other states the resource limit is $4,000 for individuals and $6,000 for couples. This may increase in 2010.

Contact the Medicare Savings Program Eligibility number at 1-800-362-1504 for help. Online, go to www.medicaid.state.al.us; go to "Apply for Medicaid", then to "Qualifying for Medicaid". About halfway down that page, at "Medicare Savings Programs", click on "Get application".

Low Income Subsidies - help with prescription drug costs

Medicare beneficiaries with incomes of no more than $16,245 ($21,855 for couples) and modest resources are eligible for help with costs associated with their prescription drug coverage. The Low Income Subsidy (LIS) program helps with monthly premiums, annual deductibles and prescription copayments. Resources must be limited to $12,510 for an individual and $25,010 for a married couple living together. An individual or couple's house, car, burial plot and personal possessions are not counted. Effective in 2010, the value of insurance and "in-kind assistance" (like someone else paying a utility bill) will also not be counted. (They are counted in 2009.)

In some cases, such as those who are eligible for both Medicare and Medicaid (through SSI), eligibility for the Low Income Subsidy is automatic. Others who may appear to be eligible may receive a letter from Social Security requesting information. If you believe you are eligible but are not automatically receiving the help or receiving an SSA inquiry, you can apply online at : www.socialsecurity.gov. Complete the Application for Help with Medicare Prescription Drug Plan Costs (Form SSA-1020). You may also call 1-800-772-1213 (TTY 1-800-325-0776), or apply in person at a Social Security office. (For help from a state SHIP counselor, see Resources, below.)

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