alt.social-security-disability

PCGumshoe wrote in news: @ :

> I think your missing something Doc...
> The QMB program provides the following benefits:
>
> *Payment of Medicare Part A monthly premiums (when applicable).
> *Payment of Medicare Part B monthly premiums and annual
> deductible.
> *Payment of co-insurance and deductible amounts for services
> covered under both Medicare Parts A and B.
>
> This means YOU DON'T PAY TO SEE A DOCTOR, as long as that doctor is a
> provider under your state's Medicare Program.
>
> Medicare + QMB = 100% Paid!
> Income must be no more than 100% FPL
>
> Medicare + SLMB = Monthly premium's are paid
> Income limit 100% - 120% FPL
>
> Medicare + Q1 (SLMB group 2) = Monthly premium's are paid
> Income limit 120% - 135% FPL
>
> QMB, SLMB and Q1 are run by the states (since they run the Medicaid
> Programs) The programs could be different from state to state and not
> knowing what state you live in I can only regurgitate what I know from
> my current state of Florida.
>
> I think you need to check again about what Medicaid sees as a
> household... if you share food and cook meals together, then you are a
> household (even your partner - since she isn't your wife). However,
> if someone is living in your house and they buy, prepare and eat their
> own meals, they are essentially considered a different household.

That might be the way your state runs things, but not here.

For me, QMB pays only the part B premium. I barely, at 988 a month, qualify for that.
I get a whole $100 a month in foodstamps. Works out to about $3 a day for food.

If it weren't for my son (who is leaving in a couple days) and my SO and her daughter paying thier
share of the bills, I wouldn't be able to exist at all. And yes, I cheat and eat some of thier
food since I certainly dont have enough to buy food myself.

You are technically correct about the Medicaid household. However, as a single male I
automatically don't qualify. So that is out.
If I were on -normal- Adult and Family Services accounts, I might qualify (but then again, probably
not) But I am with Senior and Disabled Services and they seem to operate under other, unwritten
rules. I have argued with my case worker and her boss, and the person at the appeals office.
Bottom line is, if they say I have to claim something, I have to. If I don't, they will cancel my
assistance. Period.

Here is Oregon's QMB (I qualify only for the QMB-SMB):

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Benefit Packages
QMB has four benefit packages based on an individual’s income. The amounts listed are for 2006-
2007.

1. Qualified Medicare Beneficiaries – Basic (QMB-BAS). In this benefit package the Department of
Human Services pays for eligible clients’ Medicare premiums, deductibles and co-insurance. The
income limit for this program is set at 100 percent of the poverty level or $871 for an individual
and $1,161 for a couple.

2. Qualified Medicare Beneficiaries – Disabled Worker (QMB-DW). In this package the Department
pays for the Medicare Part A premiums for some disabled workers who lost eligibility for Social
Security because they are working. The income limit for this program is set at 200 percent of the
poverty level or $1,722 for single person and $2,302 for a couple.

3. Qualified Medicare Beneficiaries – Specified Low-Income Medicare Beneficiary (QMB-SMB and
SMF). In this benefit package, the Department only pays for the Medicare Part B premiums of
eligible clients. The federal government pays for a portion of the cost of the SMB and SMF
programs. The income limit for SMB is set at 120 percent of the poverty level or $1,041 for
individuals or $1,389 for a couple. The federal government pays 60 percent of this benefit.

The federal government also mandates that we serve people with incomes between 120 percent
and 135 percent of the poverty level which equals $1,169 for an individual and $1,561 for a couple.
This is called the SMF benefit. Unfortunately, we are only allowed to serve a specific number of
people each year in this category. Once we reach our maximum number we must shut down enrollment.
The federal government pays 100 percent of the SMF program.

Please note: Institutionalized clients ( . Nursing Facility residents) are not eligible for
the SMF program.

For all QMB programs the allowed resource (asset) limit is set at $4000 per individual or $6000 per
couple. This does not include your home, car, burial plan ($1,500) and merchandise.
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