What Medicaid Covers for Medicare Enrollees
Medicare has four basic forms of coverage :
- Part A: Pays for hospitalization costs
- Part B: Pays for physician services, lab and x-ray services, durable medical equipment, and outpatient and other services
- Part C: Medicare Advantage Plan (like an HMO or PPO) offered by private companies approved by Medicare
- Part D: Assists with the cost of prescription drugs
Medicare enrollees who have limited income and resources may get help paying for their premiums and out-of-pocket aesculapian expenses from Medicaid ( e.g. MSPs, QMBs, SLBs, and QIs ). Medicaid besides covers extra services beyond those provided under Medicare, including harbor facility worry beyond the 100-day specify or skilled harbor facility care that Medicare covers, prescription drug drugs, eyeglasses, and hearing aids. Services covered by both programs are first paid by Medicare with Medicaid filling in the difference up to the state of matter ‘s payment limit .
2022 Dual Eligible Standards
(Based on Percentage of Federal Poverty Level)
Qualified Medicare Beneficiary (QMB):
monthly Income Limits : ( 100 % FPL + $ 20 ) *
Region | Individual | Couple |
---|---|---|
All States and DC (Except Alaska & Hawaii) |
$1,153 | $1,546 |
Alaska | $1,436 | $1,928 |
Hawaii | $1,323 | $1,775 |
Asset Limits | $8,400 | $12,600 |
* $ 20 = Amount of the Monthly SSI Income Disregard
Specified Low-Income Medicare Beneficiary (SLMB):
monthly Income Limits : ( 120 % FPL + $ 20 ) *
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Region | Individual | Couple |
---|---|---|
All States and DC (Except Alaska & Hawaii) |
$1,379 | $1,851 |
Alaska | $1,719 | $2,309 |
Hawaii | $1,583 | $2,126 |
Asset Limits | $8,400 | $12,600 |
* $ 20 = Amount of the Monthly SSI Income Disregard
Qualifying Individual (QI):
monthly Income Limits : ( 135 % FPL + $ 20 ) *
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Region | Individual | Couple |
---|---|---|
All States and DC (Except Alaska & Hawaii) |
$1,549 | $2,080 |
Alaska | $1,932 | $2,596 |
Hawaii | $1,779 | $2,390 |
Asset Limits | $8,400 | $12,600 |
* $ 20 = Amount of the Monthly SSI Income Disregard
Qualified Disabled Working Individual (QDWI):
monthly Income Limits : ( 200 % FPL + $ 20 ) *
( Figures include extra earn income disregards )
Region | Individual | Couple |
---|---|---|
All States and DC (Except Alaska & Hawaii) |
$4,615 | $6,189 |
Alaska | $5,749 | $7,715 |
Hawaii | $5,295 | $7,105 |
Asset Limits | $4,000 | $6,000 |
* $ 20 = Amount of the Monthly SSI Income Disregard