Qualified Medicare Beneficiary Program
The State of Utah, Department of Human Services, Division of Aging and Adult Services, Health Insurance Information Program, is committed to making available as much information as possible to ensure beneficiaries make informed choices a bout their health insurance.
The Health Insurance Information Program does not determine eligibility for, or administer any of the services mentioned in this web site. Please contact the appropriate agencies directly for your individual determination of eligibility and services.
The Qualified Medicare Beneficiary Program is one of two free Medicare supplement programs for qualified persons. This program pays Medicare premiums for Medicare Part A, (Hospital), and Part B, (Medical), insurance. It also pays the yearly deductible for both Part A and Part B, and all Medicare co-payments.
To determine if the Qualified Medicare Beneficiary Program applies to your individual situation, please contact us directly at our toll free number: 1-800-541-7735
General Information Included on this Web Page
Eligibility
There are three criteria to qualify for the Qualified Medicare Beneficiary Program:
- You must be eligible for Medicare Part A, (Hospital coverage).
- Your assets, (bank accounts, stocks and bonds, for example), must be less than $4000 for a single person or $6000 for married persons. We do not count your home and furnishings, a vehicle you use to go to medical care, and some types of burial plans as assets.
- Your monthly income, after deductions, must be less than $696 per month for single persons, or $938 for married persons if both are eligible for Medicare. The income deduction for Social Security and other retirement and d isability benefits is $20. There are other deductions if you are working.
(See also Qualified Individual Program for 2 new Programs)
Enrollment
You must fill out an application form, have a short interview and provide proof of your income and assets, and a few other items which are noted below under "What Proofs Must I Provide ? ".
Applications are available in your local Bureau of Eligibility Services or Department of Workforce Services. (Look in the telephone book under State of Utah, Department of Workforce Services.) An application may be mailed to you. You can also call the Medicaid Information Line at (801) 538-6155. Toll-free, call 1-800-662-9651. Ask for an application for the Specified Low-Income Medicare Beneficiary Program.
What Proofs Must I Provide?Some of the things you and your spouse will need to verify your eligibility include:
- Birth Certificate
- Identification
- Social Security Number
- Medicare Number
- Proof of Income
- Bank Statements
- Vehicle Registration
- Deed and Tax Assessment to your home and any other real estate you own.
- Proof of any other assets you own such as certificates of deposit, life insurance, stocks, bonds, etc.
- Burial Plans
- Proof of any Health Insurance
- Other items as requested by your eligibility worker.
Coverage
The Qualified Medicare Beneficiary Program is a Medicare Insurance supplemental program only. This program supplements Medicare premiums for Medicare Part A, (Hospital), and Part B, (Medical), insurance. It also pays the yearly deductible for both Part A and Part B, and all Medicare co-payments. The program does not cover health care costs that Medicare won't pay. If you have expenses for prescriptions, vision and dental care, hearing aids, podiatry, or nursing home care, you may wish to apply for Medicaid at the same time you apply for this program.
Qualified Individual Program
The Balanced Budget Act of 1997 has added two new groups of people to the Qualified Medicare Beneficiaries type of coverage. Qualifying individuals cannot be receiving any other form of Medicaid.
- Qualified Individual Group 1 - The benefit of this program is that the state will pay the full amount of the
Part B Medicare premium if you meet the eligibility requirements.
- You must be eligible for Medicare Part A, (Hospital coverage).
- Your assets, (bank accounts, stocks and bonds, for example), must be less than $4000 for a single person or $6000 for married persons. We do not count your home and furnishings, a vehicle you use to go to medical care, and some types of burial plans as assets.
- Your monthly income, after deductions, must be less than $940 per month for single persons, or $1266 for married persons if both are eligible for Medicare. The income deduction for Social Security and other retirement and disability benefits is $20. There are other deductions if you are working.
- Qualified Individual Group 2 - The only benefit received under this program is that the state will refund
a small portion of the Part B Medicare premium, ($2.87 per month in 2000). Payment of this benefit will be in the form
of a refund check at the end of the calendar year.
- You must be eligible for Medicare Part A, (Hospital coverage).
- Your assets, (bank accounts, stocks and bonds, for example), must be less than $4000 for a single person or $6000 for married persons. We do not count your home and furnishings, a vehicle you use to go to medical care, and some types of burial plans as assets.
- Your monthly income, after deductions, must be less than $1218 per month for single persons, or $1641 for married persons if both are eligible for Medicare. The income deduction for Social Security and other retirement and disability benefits is $20. There are other deductions if you are working.