2014 SCADC Alabama Benefit Checklist (effective 07-01-14)

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

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2014 SCADC Alabama Benefit Checklist (effective 07-01-14)

  1. 1. 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& 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.& Effective 07-01-14
  2. 2. 3& 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. 3. 4& SSI and Community Medicaid Benefit Eligibility Standard 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 Effective Date/Change Date 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 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 Effective Date/Change Date Single Standard 01-14/01-15 Married Spousal Resource Set Aside Standard . 01-14/01-15
  4. 4. 5& $117,240 Monthly Spousal Allotment $1966.25 07-14/07-15 Transfer Penalty 1 month for every $5500 transferred 01-14/01-15 Home exclusion Equity at or below $543,000 01-14/01-15 Medicare&Savings&Programs&(MSP) Benefit Eligibility Standard MSP Program Single Income/Resources (includes $20 disregarded) Married Income/Resources (Includes $20 disregarded) QMB Pays for: ~uncovered Medicare expenses to replace purchase of Medicare supplemental policy; ~Medicare Part B premium ~Medicare Part D premium up to State Standard* $993 $1331 SLMB Pays for: ~Medicare Part B $1187 $1593 Effective Date/Change Date 02-18-14/03-15
  5. 5. 6& premium QI-1 Pays for: ~Medicare Part B premium $1333 $1790 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 $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 Skilled nursing facility $152 per day for days 21 - 100 B $104.90 per month standard premium if drawing in 2012 Premium for higher income beneficiaries below $147.00 20% Effective Date/Change Date 01-14/01/15
  6. 6. 7& 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 Married with Separate Tax Return Part B Premium Amount $85,000 or less $170,000 or less $85,000 or less Standard $104.90 Over $85,000 up to $107,000 Over $170,000 up to $214,000 N/A $146.90 Over $107,000 up to $160,000 Over $214,000 up to $320,000 N/A $209.80 Over $160,000 up to $214,000 Over $320,000 up to $428,000 Over $85,000 up to $129,000 $272.70 Over $214,000 Over $428,000 Over $129,000 335.70 Effective Date/Change Date 01-14/01/15 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 Married with Separate Tax Return Part D Premium Amount $85,000 or less $170,000 or less $85,000 or less Your plan premium Effective Date/Change Date 01-14/01/15
  7. 7. 8& Over $85,000 up to $107,000 Over $170,000 up to $214,000 N/A $12.10 + your plan premium Over $107,000 up to $160,000 Over $214,000 up to $320,000 N/A $31.10 + your plan premium Over $160,000 up to $214,000 Over $320,000 up to $428,000 Over $85,000 up to $129,000 $50.20 + your plan premium Over $214,000 Over $428,000 Over $129,000 $69.30 + your plan premium Medicare Late Enrollment Penalties Part B 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 Permanent Part D Late Enrollment Penalty 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 Enrollment Periods Standard Part D Premiums Low Income Subsidy (Extra Help purchasing Medicare Part D) Benefit Categorical Eligibility Effective Date/Change Date
  8. 8. 9& 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 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 Income/Resources Married 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 Income/Resources Married Income/Resources Living Together C.LIS (Full Subsidy) 1332.88/<13,440 1789.63/<26,860 01-14/01-15
  9. 9. 10& 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 Income/Resources Married 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 Income/Resources Married 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 LIS (Partial Subsidy) C. People eligible for Medicare at or below 150% of the poverty level with limited resources below (25%
  10. 10. 11& subsidy) Single Income/Resources Married Income/Resources Living Together 1478.75/<13,440 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 *Premium State Standard $31.30 Effective Date/Change Date 01-14/01-15 Social Security Normal Retirement Age (NRA) Born NRA 1937 and prior 65 1938 65 and 2 months 1939 65 and 4 months 1940 65 and 6 months 1941 65 and 8 months Effective Date/Change Date Permanent
  11. 11. 12& 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 Reduction of benefits when retire at 62 Reduction of benefits when retire at 63 Reduction of benefits when retire at 64 Reduction of benefits when retire at 65 NRA 66 (born 1943 or later) 25% 20% 13.3% 6.7% NRA after 66 (born after 1954) 30% Effective Date/Change Date 01-13/01-14 Early Retirement Earned Income Offset
  12. 12. 13& Category Based on NRA Exempt Amount SS Offset Penalty Exempt Earnings for early retirees/workers whose NRA IS NOT in 2014 $15,480 Withholding of $1.00 in benefits for every $2.00 earned over $15,480 Exempt Earnings for early retirees/workers whose NRA IS in 2014 and earnings predated reaching NRA $41,400 Withholding of $1.00 in benefits for every $3.00 earned over $41,400 Effective Date/Change Date 01-14/01-15 SSD Substantial Gainful Activity (SGA) Category Based on Disability Allowable Mo. Earnings Non-blind $1070.00 Blind $1,800.00 Effective Date/Change Date 01-14/01-15
  13. 13. 14& Alabama Elderly Simplified Application Project (AESAP) Food Assistance for 60+ Household Size Gross Income Limit Net Income Limit 1 $1245 $958 2 $1681 $1293 3 $2116 $1628 4 $2552 $1963 5 $2987 $2298 6 $3423 $2633 7 $3858 $2968 8 $4294 $3303 Each Additional Member $ 436 $ 335 Effective Date/Change Date 10-1-13/10-01-14 Gift and Estate Tax Federal Estate Tax Exemption and Lifetime exclusion for gifts $5,340,000 2014/2015 Annual Gift Exclusion $14,000 2014/2015

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