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Eligibility for Savings on Medicare

Baltimore County State Health Insurance Assistance Program (SHIP), Phone: 410-887-2059

Save on Prescription Drug Plan Costs

Maryland Senior Prescription Drug Assistance Program (MD SPDAP)

Gross Income

Assets

Assistance

What You Need To Do

Under
$38,640 (Single)
$52,260 (Couple)

Not counted

Up to $50 toward the monthly premium

Apply through MD SPDAP: Call 1-800-551-5995 or visit the Senior Prescription Drug Assistance Program website.

Social Security Administration Extra Help and Low Income Subsidy

Gross Income

Assets

Assistance

What You Need To Do

Under $19,560 or $1,630 per month (Single)
Under $26,370 or $2,198 per month (Couple)

Under $14,790 (Single)*
Under $29,520 (Couple)*

*Includes $1500 per person burial allowance

  • Sliding scale assistance on the monthly premium
  • Deductible $92
  • Drug co-payments: 15 percent or less

(Partial Extra Help)

  • Apply through Social Security: Call 1-800-772-1213 or visit the Social Security Administration website.
  • Also apply for MDSPDAP to pay for the portion of the premium not covered by Partial Extra Help. Call 1-800-551-5995.

Under $17,628 or $1,469 per month (Single)
Under $23,757 or $1,980 per month (Couple)

Under $9,470 (Single)*
Under $14,960 (Couple)*

*Includes $1500 per person burial allowance

  • Monthly premium
  • No deductible
  • $3.70 generic drug
  • $9.20 brand name drug

(Full Extra Help)

  • Apply through Social Security: Call 1-800-772-1213 or visit the Social Security Administration website.
  • May also be eligible for QMB or SLMB. For an application, call Baltimore County SHIP or the Department of Social Services.

Full Medical Assistance Eligible
red and white card)

Full Medical Assistance Eligible

  • No premium
  • No deductible
  • $1.30 generic drug
  • $4 brand name drug

(Full Benefit Dual Extra Help)

  • Automatically enrolled in Extra Help. Do not apply through Social Security.
  • Medicare premiums, deductibles and co-pays will be paid through the Department of Social Services.

Definitions

  • Assets: Iras, CD, Savings, Checking, Annuities, etc. Primary house and car not counted as assets or resources.
  • Income: Gross pension, social security, alimony, worker's compensation, etc.
  • Couple: Defined as married and living together
  • Wages: Deduct $65 from gross wages for each month worked and divide the sum by two. This figure is the amount of wages to be used when determining eligibility.

*2021 Premium Benchmark: $29.65 (For plans below the benchmark, there is no premium)

Department of Social Services (Medicare Savings Programs)

  • Save on Part A and Part B premiums, deductibles and co-payments
  • Pays for Medicare Part B monthly premium

Qualified Medicare Beneficiary  (QMB)

Annual and Monthly Gross Income

Resources

What You Need To Do

$13,116 or $1,093 per month (Single)
$17,660 or $1,472 per month (Couple)

$7,970 (Single) *
$11,960 (Couple) *

For an application, call Baltimore County SHIP at 410-887-2059 or the Department of Social Services.

*Assets do NOT include $1500 per person burial allowance (must be in a dedicated account)

Once the application has been processed, the Department of Social Services sends a letter to tell client if they are eligible. If eligible, a gray and white paper card will be received.

  • Pays for Part A and Part B monthly premium, deductibles and co-payment

Specified Low-Income Medicare Beneficiary (SLMB)

Annual and Monthly Gross Income

Resources

What You Need To Do

$17,628 or $1,469 per month (Single)
$23,757 or $1,980 per month (Couple)

$7,970 (Single) *
$11,960 (Couple) *

For an application, call Baltimore County SHIP at 410-887-2059 or the Department of Social Services.

*Assets do NOT include $1500 per person burial allowance (must be in a dedicated account)

Once the application has been processed, the Department of Social Services sends a letter to tell the client if they are eligible. No card will be received.

 

Note: Wages for QMB or SLMB: Deduct $65 from gross wages for each month worked and divide the sum by two. This figure is the amount of wages to be used when determining income eligibility.

All QMB or SLMB beneficiaries receive a Case Information Form (CIF) each year to be reviewed and returned so eligibility for continued QMB or SLMB benefits can be determined.

If the form is not returned by the due date, your benefits will end.

 
Revised March 19, 2021         

 

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