Benefits Roster - 2010 Eligibility

Adult Day Care:   Medical Assistance Reimbursement - $73.27  (Effective 7/1/09)

2009  Federal Poverty Guidelines*

*Figures are rounded out to nearest dollar amount.

Medicare 2010:

Medicare Part A:  

Hospital Deductible:  You pay $1,100 per benefit period (Medicare pays for benefit period of 60 days.)

Coinsurance:  You pay $275 per day co-payment for days 61-90.

Coinsurance:  You pay $550 per day for days 91-150. These are nonrenewable lifetime reserve days.
                       You pay all costs for each day beyond 150 days.

Skilled Nursing Facility Coinsurance (after hospital stay of at least 3 consecutive days):
You pay $137.50 per day (per benefit period) for days 21-100 (days 1-20 are covered in full by Medicare).
You pay all costs after day 100 in the benefit period.
No coverage is provided for custodial or intermediate Nursing Home care.

Medicare Part B:

Deductible:  You pay $155 per year.

Co-Payment:  You pay 20 percent co-payment for Medicare-approved charges.

Monthly Premium:  See table below:

*$96.40 if beneficiary has SSA withhold in 2009; $110.50 for all others

Part D Medicare Prescription Drug Program:  You pay a deductible up to $310 in 2010.

Spousal Impoverishment Standards:

This applies to couples when one spouse begins a continuous period of residence in a nursing home and subsequently applies for Medicaid. All non-exempt assets (savings and checking accounts, stocks, bonds, etc.) owned by either spouse, jointly or separately, are pooled as of the date of institutionalization.

The spouse living in the community may keep the amount of the assets as specified below. The remaining assets are used to pay for nursing home care or other eligible expenses, until the institutionalized spouse's assets reach the Medicaid eligibility level of $2,500.  

The Community Spouse's income will be evaluated to determine how much, if any, of the institutionalized spouse's monthly income can be allowed for the community spouse's monthly maintenance allowance. This maintenance allowance will supplement the community spouse's own income up to $1,821/month. If shelter expenses exceed $546/month, an additional amount will be allowed. The maximum total allowance cannot exceed $2,739/month.

(Sum of Basic Maintenance & Shelter Allowance and Excess Shelter Allowance)

Call Senior Information and Assistance at 410-887-2594 for additional information.  

Revised December 22, 2009