Medicare Savings Programs - Click to view assest limits
Medicare Savings Programs – Click to view assest limits

Medicare Savings Programs

Ca Health Advocates.org  (SHIP)

  1. Qualified Medicare Beneficiary (QMB)
  2. Specified Low-Income Medicare Beneficiary (SLMB)
  3. Qualified Individual (QI)
  4. Qualified Disabled Working Individual (QDWI)
  5. 250% California Working Disabled (CWD)
  6. How to Apply

Disability Benefits 101

 

Categories of dual eligible beneficiaries
and out-of-pocket costs that must be paid by Medi-Cal – Medicaid:

Medicare Savings Programs (MSP’s)  ⇒  CA Health Advocates

Qualified Medicare Beneficiary  (QMB)

  • Medicare Part A and Part B premiums; ♦ cost sharing for Part A & Part B benefits.
  • QMB Plus – Medicare Part A and Part B premiums; cost sharing for Part A & Part B benefits; Full Medicaid benefits.
  • SLMB (only) (Specified Low-Income Medicare Beneficiary) – Medicare Part B premium.
  • SLMB Plus – Medicare Part B premium; Full Medicaid benefits.
  • QI (Qualifying Individual) – Medicare Part B premium.
  • Other FBDE (Full Benefit Dual Eligible) – Medicare Part B premium; Full Medicaid benefits.
  • QDWI (Qualified Disabled & Working Individual) – Part A premium. (AHIP Training * Medicare & You  *  CA Health Advocates)

medi helper.com  They can help you qualify… they do charge a fee based on the complexity of the case.   Free Intake – Assessment Form

Medicare.Gov – Savings Programs

Protecting Dual Eligibles from Balance Billing – Justice in Aging.com   Power Point

 

Medicare Savings Programs 2 minutes

QMB

Specified Low Income  SLMB

Q I  Qualified Individual

Qualified Disabled Working Individual  QDWI

What Medi-Cal Covers

Can have MAPD

Share of Cost

Full Medi-Cal – pays Part A

How to apply for Medi-Cal?

Dual Demonstration Project – Cal Medi Connect

Can get MAPD too – stability, committement, qualify products – quality medical groups –

Plan 1 all UHC

Plan 2 – Health Care Partners – lower co pays

Plan 3 transportation, full network, ancillary benefits   look a like plan, includes transportation

How to verify between Cal Medi Connect shows pcp  and Medi-Cal Plan – no MD show

Show MAPD card, then don’t have to show Medi-Cal card

Medi-Cal picks up co pays

Continuous SEP

Share of Cost vs Fully qualified

Can no longer dual SNP  – look a like plans are OK

 

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