This article was published in the August 1999 issue
of POZ Magazine.
It is reprinted here by permission.
If you're a cash-strapped PWA who has survived
the two-year, post-disability wait for Medicare, you may be eligible for
two money-saving benefits. The Specified Low Income Medicare Beneficiary
(SLIMB) program pays the $45.50 monthly premium for Medicare Part B (which
covers doctor bills and outpatient care) that's automatically deducted
from Social Security Disability Insurance (SSDI) checks. And the Qualified
Medicare Beneficiary (QMB) program pays the $768 hospital-admission deductible,
the $100 annual doctor-bill deductible and the 20 percent copayment required
for doctor and outpatient bills.
SLIMB recipients must have a monthly income
under $947; for QMB benefits, it's less than $707. But your total SSDI
benefit is what counts against the $947 and $707 eligibility. That means
you must add the $45.50 Medicare deduction from your SSDI to get the total
countable income. Both the SLIMB and the QMB programs are administered
through each state's Medicaid program, but you must apply at your local
welfare office. Bring your birth certificate, bank account statement and
other asset records, deeds, leases, utility bills, auto registration, a
picture ID and, most important, your Medicare card and the latest letter
from Social Security (available from 800.722.1213) stating your SSDI benefit
total.
If you return to work, as long as you are
considered disabled, you are still eligible for Medicare. That's a good
idea, even if you receive health coverage through your employer. Medicare
covers many things that regular work plans don't, including unlimited psychiatric
and substance-abuse treatment and home health benefits. And it won't lapse
if you are laid off or become too sick to work again.
If you're working and off SSDI, SLIMB will
pay your premium as long as your gross monthly wages stay below $1,939
(or more if you're paying out-of-pocket medical expenses). The QMB program
will pay the premium plus deductibles and copayments with earnings of up
to $1,458 monthly. After you've been back at work for 45 months, Medicare
Part A (which covers overnight hospital and home-health care) starts charging
a premium of either $170 or $309 monthly, depending on your work history.
But if your total monthly salary is below $2,832, the Qualified Working
Disabled Individuals (QDWI) program will pay your Part A premium; apply
at your local welfare office.