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Beneficiary Qualifications for Medicare Part D Subsidies

October 26th 2005

Beneficiary Qualifications for Medicare Part D Subsidies

Medicare Card

Those that have Medicare - (Note: You must have both Part A and B of Medicare to qualify for the "Advantage" plan – Whether or not you qualify for a subsidy), and are of 135% of the FPL (Federal Poverty Level) – Income of less than $12,920 per individual or $17,321 per married couple. Assets of less than $7,500 per individual and less than $12,000 per married couple will qualify for a subsidy. The COST And Premium will be ZERO – You will pay $2.00 per generic and $5.00 brand name prescription drugs. Again, NO GAP IN COVERAGE.

The next 2 subsidies can be tricky – BUT – just follow closely – I will break the subsidy qualification as clearly as I can: Read and reread carefully.

# 1 -: If your Income is less than $12,290 per individual and less than
$17,321 per married couple. Take a breather – because this income allotment is the same as the above – But take Note of the Asset change. Assets: more than $7,500 - BUT less than $11,500 per individual and assets of more than $12,000 per individual and less than $23,000 per married couple, you qualify.
Cost and benefits: No premium – an annual deductible of $50.00 and then the next amount of your cost should average of 15% for each prescription – NO GAP IN COVERAGE – after your prescriptions exceed $5,100 you will pay $2.00 per generic and $5.00 for brand name prescriptions.

 

# 2 -: Income – At or above $12,290 per individual and less than $14,355, for a married couple - At or above $17,321 and less than $19,245. Assets – less than $11,500 or less than $$23,000 per married couple.
Benefits: This qualified plan will also have a $50.00 deductible and then the next amount of your cost should average of 15% for each prescription – NO GAP IN COVERAGE – after your prescriptions exceed $5,100 you will pay $2.00 per generic and $5.00 for brand name prescriptions.

COST - of this plan is somewhat different, and is totally dependent is your personal FPL.
# A - Between 136% and 139% of FPL - CMS will pay 75% of your premium.
# B - Between 141% and 144% of FPL - CMS will pay 50% of your premium.
# C - Between 146% and 149% of FPL – CMS will pay 25% of your premium.
EXAMPLE: If your qualified base or standard plan, cost will be $20.00 per month – A. will pay $15.00 – B. will pay $10.00 – C. will pay $5.00 of your monthly premium.

 
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Centers for Medicare and Medicaid Services: (877) 267-2323 or the CMS website.

Medicare has a toll free number you can call to ask questions.  There phone number is 1-800-633-4227.  TTY users should call 1-877-486-2048.  You can visit official Medicare website here.

Medicare Part D
 

By Dan Rohan
Dan’s columns are currently published in a number of states, with a heavy concentration in central Florida. Dan is published somewhere 5 days per week; his column is published as “Senior Advocate” and syndicated as “Senior Focus.”  Contact Dan
Attention Editors: If your publication or Internet site would like to carry Dan's weekly column - Contact Dan for all Information. "Senior Focus" is also available to the general public - Contact Dan for info on a weekly e-mailed subscription basis.
 

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Copyright 2005 Best Syndication                                            Last Updated Saturday, July 10, 2010 09:46 PM