Alabama Benefit Checklist (effective 02-14)

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Information about Alabama Benefit Checklist (effective 02-14)
Education

Published on February 20, 2014

Author: jan_neal

Source: slideshare.net

Description

Public benefits chart with eligibility requirements for programs, many particular to Alabama

South& Central& Alabama& Development& Commission& Area&Agency&on&Aging& Aging&and Disability& Resource& Center& (ADRC)& State& Health& Insurance& Program& (SHIP)& Alabama&Benefit&Checklist& Assembled&by&Jan&Neal& Effective 03-07-14 This& publication& has& been& created& or& produced& by& South& Central& Alabama& Development& Commission,& Area& Agency& on& Aging,& Aging& and Disability& Resource& Center& (ADRC)& with& financial& assistance,& in& whole& or& in& part,& through& a& grant& from& the& Centers& for& Medicare& and& & Medicaid& Services,& the& Federal& Medicare& agency.&

Table&of&Contents& SSI&and&Community&Medicaid………................................................ 4& Institutional&Medicaid&and&Community&Medicaid&Waiver……..….4& Medicare&Savings&Programs&(MSP):&QMB,&SLMB,&QIP1………. .......5& Medicare&Standard&A&&&B&Cost&Sharing………. ............................... 6& Medicare&Higher&Income&A&&&D&Cost&Sharing………....................... 7& Medicare&Late&Enrollment&Penalties……..........................................…...8& Low&Income&Subsidies….......................................................................……..8& Social&Security&Retirement&Age……....................................................….11& Social&Security&Early&Retirement&Benefit&Reductions……........….12& Social&Security&Early&Retirement&Earned&Income&Offset……...….12& Social&Security&Disability&Substantial&Gainful&Activity………. ..... 13& Alabama&Elderly&Simplified&Application&Project……… ................14& Gift&and&Estate&Tax………................................................................ 14& 3&

SSI and Community Medicaid Benefit Eligibility Standard Effective Date/Change Date SSI Retirement and Disability Single Monthly Income/Resources $741/$2000 Married Monthly Income/Resources $1102/$3000 Medicaid at Home SSI eligibility SSI eligibility Medicare Buy-In for Medicare A, B & D SSI eligibility SSI eligibility 01-14/01-15 Institutional Medicaid/Community Medicaid Waiver Benefit/Penalty Eligibility Standard Nursing Home Medicaid Single Person Income/Resources $2163 (with income over $2163 MQIT needed)/ $2000 Effective Date/Change Date Married Couple Income/Resource Set Aside $2163 (only income of spouse being institutionalized counts)/First $27,000 set aside for community spouse, resources over $50,000, ½ set aside for spouse up to cap of Single Standard 01-14/01-15 Married Spousal Resource Set Aside Standard 07-13/07-14 4&

$117,240 Monthly Spousal Allotment Transfer Penalty Home exclusion $1939 07-13/07-14 1 month for every $5500 transferred Equity at or below $543,000 01-14/01-15 01-14/01-15 Medicare&Savings&Programs&(MSP) Benefit Effective Date/Change Date Eligibility Standard 02-18-14/03-15 MSP Program Single Income/Resources (includes $20 disregarded) QMB $993 Pays for: ~uncovered Medicare expenses to replace purchase of Medicare supplemental policy; ~Medicare Part B premium ~Medicare Part D premium up to State Standard* SLMB $1187 Pays for: ~Medicare Part B Married Income/Resources (Includes $20 disregarded) $1331 $1593 5&

premium QI-1 Pays for: ~Medicare premium $1333 Part $1790 B Medicare Medicare Part Premium Deductible Copayment A 0 if eligible for SS (Retirement benefits; 24 months of disability) or RR or paid Medicare Tax with Civil Service; $426 per month with fewer than 30 qrts.; $234 per month with 30 – 39 quarters $104.90 per month standard premium if drawing in 2012 $1216 per admission to hospital during a spell of illness $304 per day for days 61 – 90; $608 per day for days 91 – 150 lifetime reserve B Effective Date/Change Date 01-14/01/15 Skilled nursing facility $152 per day for days 21 - 100 $147.00 20% Premium for higher income beneficiaries below 6&

Medicare Part B Premium for Higher Income Beneficiaries Based on Two Year’s Prior Yearly Reported Income Individual Tax Return Filed Joint Tax Return Filed $85,000 or less $170,000 or less Over $85,000 up to $107,000 Over $107,000 up to $160,000 Over $160,000 up to $214,000 Over $214,000 Over $170,000 up to $214,000 Over $214,000 up to $320,000 Over $320,000 up to $428,000 Over $428,000 Married with Separate Tax Return $85,000 or less Part B Premium Amount Effective Date/Change Date Standard $104.90 01-14/01/15 N/A $146.90 N/A $209.80 Over $85,000 up to $129,000 Over $129,000 $272.70 335.70 Medicare Part D Premium for Higher Income Beneficiaries Based on Two Year’s Prior Yearly Reported Income Individual Tax Return Filed Joint Tax Return Filed $85,000 or less $170,000 or less Married with Separate Tax Return $85,000 or less Part D Premium Amount Effective Date/Change Date Your plan premium 01-14/01/15 7&

Over $85,000 up to $107,000 Over $107,000 up to $160,000 Over $160,000 up to $214,000 Over $214,000 Over $170,000 up to $214,000 Over $214,000 up to $320,000 Over $320,000 up to $428,000 Over $428,000 N/A N/A Over $85,000 up to $129,000 Over $129,000 $12.10 + your plan premium $31.10 + your plan premium $50.20 + your plan premium $69.30 + your plan premium Medicare Late Enrollment Penalties Part B Late Enrollment Penalty Part D Late Enrollment Penalty 10% per each full 12 – month period eligible without coverage X cost of Medicare Part B premium at time of sign up = amount added to monthly cost of Part B premium 1% of the “national base beneficiary premium” ($32.42 in 2014; $31.17 in 2013) X the number of full, uncovered months eligible without coverage or creditable coverage = amount added to monthly cost of Part D Permanent Permanent Enrollment Periods Standard Part D Premiums Low Income Subsidy (Extra Help purchasing Medicare Part D) Benefit Categorical Eligibility Effective Date/Change Date 8&

calculate income: add income (gross earned income or net from self-employment minus 65 divided by 2) + all other income calculate resources: do not count home, adjoining land, household personal property, vehicles or life insurance C.LIS (Full Subsidy) 01-14/01-15 A. People eligible for Medicare and Medicaid who live in nursing facilities or receive home and community based waiver NOTE: Automatically receive benefit and pay no monthly premium*, no annual deductible and no copayments for drugs. B. People eligible for Medicare and Medicaid who apply and income is at or below 100% of the poverty level with limited resources (100% subsidy) Single Married Income/Resources Income/Resources Living Together 992.50/<13,440 1330.83/<26,860 Each additional person in the home for whom applicant provides more than one-half of person’s support add 338.33 C. People eligible for Medicare and Medicaid who apply and income is at or below 135% of the poverty level with limited resources (100% subsidy) Single Married Income/Resources Income/Resources Living Together 1332.88/<13,440 1789.63/<26,860 9&

LIS (Partial Subsidy) Each additional person in the home for whom applicant provides more than one-half of person’s support add 456.75 A. People eligible for Medicare at or below $140% of the poverty level with limited resources below (75% subsidy) Single Married Income/Resources Income/Resources Living Together 1381.50/<13,440 1855.17/<26,860 Each additional person in the home for whom applicant provides more than one-half of person’s support add 473.67 B. People eligible for Medicare at or below 145% of the poverty level with limited resources (50% subsidy) Single Married Income/Resources Income/Resources Living Together $1430.13/<13,440 1920.71/<26,860 Each additional person in the home for whom applicant provides more than one-half of person’s support add 490.58 C. People eligible for Medicare at or below 150% of the poverty level with limited resources below (25% 10&

subsidy) Single Income/Resources 1478.75/<13,440 *Premium State Standard Married Income/Resources Living Together 1986.25/<26,860 Each additional person in the home for whom applicant provides more than one-half of person’s support add 507.50 $29.67 Effective Date/Change Date 01-14/01-15 Social Security Normal Retirement Age (NRA) Born NRA Effective Date/Change Date Permanent 1937 and prior 65 1938 65 and 2 months 1939 65 and 4 months 1940 65 and 6 months 1941 65 and 8 months 11&

1942 65 and 10 months 1943 – 1954 66 1955 66 and 2 months 1956 66 and 4 months 1957 66 and 6 months 1958 66 and 8 months 1959 66 and 10 months 1960 and later 67 SS Early Retirement Benefit Reduction Category based on NRA NRA 66 (born 1943 or later) NRA after 66 (born after 1954) Reduction of benefits when retire at 62 25% Reduction of benefits when retire at 63 Reduction of benefits when retire at 64 20% 13.3% Reduction of benefits when retire at 65 6.7% Effective Date/Change Date 01-13/01-14 30% Early Retirement Earned Income Offset 12&

Category Based on NRA Exempt Amount SS Offset Penalty Exempt Earnings for early retirees/workers whose NRA IS NOT in 2014 Exempt Earnings for early retirees/workers whose NRA IS in 2014 and earnings predated reaching NRA $15,480 Withholding of $1.00 in benefits for every $2.00 earned over $15,480 $41,400 Effective Date/Change Date Withholding of $1.00 in benefits for every $3.00 earned over $41,400 01-14/01-15 SSD Substantial Gainful Activity (SGA) Category Based on Disability Allowable Mo. Earnings Non-blind $1070.00 Blind Effective Date/Change Date $1,800.00 01-14/01-15 13&

Alabama Elderly Simplified Application Project (AESAP) Food Assistance for 60+ Household Size Gross Income Limit Net Income Limit Effective Date/Change Date 10-1-13/10-01-14 1 $1245 $958 2 $1681 $1293 3 4 5 6 7 8 Each Additional Member $2116 $2552 $2987 $3423 $3858 $4294 $ 436 $1628 $1963 $2298 $2633 $2968 $3303 $ 335 Gift and Estate Tax $5,340,000 Federal Estate Tax Exemption and Lifetime exclusion for gifts Annual Gift Exclusion $14,000 2014/2015 2014/2015 14&

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