Gross Income | Assets* | Assistance | What You Need To Do | Under
$16,245 (Single)
$21,855 (Couple**) (Partial) | Under
$12,510 (Single)
$25,010 (Couple**)
(Include $1,500 for burial cost) | $60 Deductible
15% co-payment of drugs up to $6,153
Sliding scale assistance toward the Drug Plan monthly premium | APPLY for Extra Help/Low Income Subsidy at Social Security
1. 800-772-1213 or www.ssa.gov
2. Enroll in a Prescription Drug Plan
3. If eligible, apply for SLMB II (see chart below).
Call SHIP for an application 410-887-2059 | Under
$14,620 (Single)
$19,669 (Couple**) (Full) | Under
$12,510 (Single)
$25,010 (Couple**)
(Include $1,500 for burial cost) | No Monthly Premium
No Deductible
$2.40 co-payment generic $6
co-payment name brand | APPLY for Extra Help /Low Income Subsidy) at Social Security
1. 800-772-1213 or www.ssa.gov
2. Enroll in a Prescription Drug Plan
3. If eligible, apply for QMB/SLMB (see chart below)
Call SHIP for application 410-887-2059 | Under
$10,830 (Single)
$14,570 (Couple**) (Full) | Under
$8,100 (Single)
$12,910 (Couple**)
(Include $1,500 for burial cost) | No Premium
No Deductible
$1.10 generic
$3.20 name brand | APPLY for Extra Help/Low Income Subsidy at Social Security
1. 800-772-1213 or www.ssa.gov
2. Enroll in a Prescription Drug Plan
3. If eligible apply for the QMB. (See chart below).
Call SHIP for application 410-887-2059 | * Assets: House and car not counted as assets/resources **Couple is defined as married and living together |
Gross Income | Assets | Assistance | What You Need To | Under
$32,490 (Single)
$43,710(Couple**) | Not Counted | Up to $25 toward the Medicare Drug Plan
Monthly premium in 2009 Up to $1,200 toward the gap (donut hole) | APPLY to Maryland Senior Prescription Drug Assistance Program (SPDAP)
1-800-551-5995
www.marylandspdap.com |
Qualified Medicare Beneficiary Program (QMB)
Pays the Medicare Part A & B monthly premium and deductibles and co-payments | | | Annual/Monthly | Resource Limit | What You Need To Do | | Individual | $11,064/ $922 | $4,000 | Call SHIP for application | | Couple | $14,808/ $1,234 | $6,000 | Call SHIP for application | | Specified Low-Income Medicare Beneficiary (SLMB I) Pays Medicare Part B Monthly Premium | | Individual | $13,236/ $1,103 | $4,000 | Call SHIP for application | | Couple | $17,724/ $1,477 | $6,000 | Call SHIP for application | | Specified Low-Income Medicare Beneficiary (SLMB II) may pay Medicare Part B Monthly Premium | | Individual | $14,856/ $1,238 | $4,000 | Call SHIP for application | | Couple | $19,908/ $1,659 | $6,000 | Call SHIP for application |
Revised March 23, 2009 |
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