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Medicaid/Medicare Buy-in Program ApplicationThe Medicaid/Medicare Buy-In Programs help people with a low income to pay their Medicare premium. Recipients can receive a substantial increase in spendable income when they no longer pay for their Medicare premium. There are three distinct Buy-in programs and each has different eligibility requirements: Qualified Medicare Beneficiary (QMB) ? Individuals who qualify for QMB are eligible to have Medicaid pay for Medicare Premiums for Parts A and B, Medicare deductibles, and Medicare coinsurance within the prescribed limits. This is the only Medicaid benefit. Eligibility requirement as of January 2008: Individual gross monthly income of $871 and asset limit = $5,000. Couple gross monthly income of $1,168 and asset limit = $6,000. Special Low Income Medicare Beneficiary (SLMB) ? Individuals who are eligible for SLMB are eligible to have Medicaid pay Medicare directly for Medicare premiums for Part B. This is the only Medicaid benefit. Eligibility requirement as of January 2008: Individual gross monthly income of $1,045 and asset limit = $5,000. Couple gross monthly income of $1,401 and asset limit = $6,000. Qualified Individuals (QI-1) - Individuals who are eligible for QI1are eligible to have Medicaid pay Medicare directly for Medicare premiums for Part B. The income limits are higher than SLMB and payment is only guaranteed through the end of the year the application was made. This is the only Medicaid benefit. Eligibility requirement as of January 2008: Individual gross monthly income of $1,176 and asset limit = $5,000. Couple gross monthly income of $1,577 and asset limit = $6,000. ApplicationsThe same application is used to apply for all three programs. It is much shorter than an application for other Medicaid programs. It is available as a paper application that can be completed and mailed to the local Department of Children and Families. Applications are available as pdf files by clicking on the links below for applications in English, Spanish or Creole or copies are available by calling the Senior Helpline at 727-217-8111 or 1-800-861-8111. Print and complete the application. Completed applications are mailed to the nearest office of the Department of Children and Families: Pasco County: New Port Richey Service Center |
