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Medicaid/Medicare

The Medicare Open Enrollment begins October 15th and goes through December 7th.

 

For more information or to make an appointment, please contact:

Area VI Agency on Aging Information & Assistance:

 

  • Andrea Leander (bi-lingual)
  • Brian Payton
  • (208) 522-5391 or (800) 632-4813
OR
SHIBA - Senior Health Insurance Benefits Advisory at (208) 236-6044

Home visits may be possible.

EICAP's Information and Assistance office can provide answers to Medicaid/Medicare related questions. The office also can assist in completing some applications for these services.

If you would like assistance or more information regarding Medicaid or Medicare, please call our Information and Assistance office at 522-5391 or email us at .

 

2013 Eligibility Income Guidelines for Medicare / Medicaid Programs

Idaho's State Medical Insurance Program (2013)
*2012 Guidelines  

Program Name

Eligibility Guidelines

Benefits

1)MEDICAID

  • for low income
  • under AABD

Note:
SSI: $710 (individual) / $1,066 (couple)

Monthly Income: $763 (individual) / $1,086 (couple)
Resources: $2,000 (individual) / $3,000 (couple)

excludes home, care, and $1,500 for burial

-other guidelines may apply, depending on individual circumstances

  • Pays hospital bills
  • Pays doctor bills for doctors who accept Medicaid
  • Pays prescription costs for those not eligible for Medicaid Part D

2) QMB (Qualified Medicare Beneficiary)

On Medicare:

Monthly Income: $951 (individual) / $1,281 (couple)
100% of poverty
Resources: $6,940 (individual) / $10,410 (couple)

excludes home, care, and $1,500 for burial

  • Pays monthly premium of $104.90
  • Pays Part A hospital deduction of $1,184.00
  • Pays Part B medical deduction of $147.00
  • Pays Part B medical co-insurance 20% of Medicare approved charge (benefits start month after date of approval).

3a) SLMB 1 (Specified Low-Income Medicare Beneficiary)

On Medicare:

Monthly Income: $1,137 (individual) / $1,533 (couple)
120% of poverty
Resources: same as QMB

  • Pays montly premium of $104.90
  • Benefit retroactive 3 months

3b) SLMB 2

 

On Medicare:

Monthly Income: $1,277 (individual) / $1,723 (couple)
135% of poverty
Resources: same as QMB

  • Pays monthly premium of $104.90 as long as the block grant lasts

4) Medicare Part D (Prescription Drug Program) - LIS

On Medicare:

Monthly Income: $1,416 (individual) / $1,911 (couple)
150% of poverty
Resources: $13,300(individual) / $26,580 (couple)

  • Pays montly premium up to $31.08*

5) Home & Community Based Services (HCBS)

Monthly Income: $2,130 (individual)
Resources: $2,000 (individual)

  • Pays portion of in-home services for eligible indivudals at home or in an assisted living facility

6) Nursing Home

Monthly Income: $2,130 (individual)
Resources: $2,000 (individual)

  • Pays portion of 24 hour Skilled Nursing Home Care


*All figures include Department of Health and Welfare $20.00 disregard for unearned income.