Qualified Medicare Beneficiary (QMB)

Name		Qualified Medicare Beneficiary (QMB) - pronounced "quimby"
Non-Financial Eligibility Conditions		This is a state program, similar to medical assistance, for people who need help paying for Medicare services. You must be eligible for Medicare Part A (even if not currently enrolled) But NOT financially eligible for medical assistance And have limited income and assets (see below)
Income Eligibility Conditions		(Apply $20 income disregard - see note below) Income not more than 100% of annual federal poverty guidelines: Individual: $837 Couple: $1,040 Effective April 2006 Income limits for eligibility in Medicare Buy-in programs may be higher in some states. Note: $20 may be subtracted from the individual's or couple's gross income; if the $20 subtraction reduces the income to the number listed above, then the individual or couple probably qualifies for the benefit. Do these numbers change?
Asset Eligibility Conditions		Assets not over: Individual: $4,000 Couple: $6,000 These limits apply to personal assets including cash, bank accounts, stocks and bonds. These limits do not include home, car or $1,500 in burial fund. Some states have no assets limit. Do these numbers change?
Benefit		Pays your Medicare part A and B deductibles, co-payments and premiums. If you are eligible for QMB, Maryland Pharmacy Assistance Program benefits will end on 12/31/05. You will be automatically transferred to the Medicare Prescription Drug Program.
Apply At		Department of Social Services. Find your local DSS Office
Appeals		You can appeal any denial, termination, or reduction of benefits Appeals must be filed in writing at the DSS office. It is best to file it in person and to get a receipt showing that you filed the appeal. Appeals must be filed within 90 days of the action, or you cannot appeal. If you file within 10 days of notice that benefits are being terminated or reduced, they will continue until the decision. If you do not appeal within 10 days, the termination or reduction will happen.
Source of the Funds		State and federal
You Also Would Be Eligible For
Sources of Law		Federal Law: 42 U.S.C. , Chapter 7, Subtitle XIX Federal Regulations: 42 C.F.R. § 400.200 Medicare, defines Qualified Medicare Beneficiary as it applies to Medicare. Federal Policy Materials: The Department of Health and Human Services has available on its web site various manuals available to view. Maryland State Law: COMAR 10.09.24.03-3
Other		In each county and in Baltimore City, the Senior Information and Assistance offices help the elderly with information about community services, health care, housing, income and financial aid, as well as transportation; employment and training, and legal services. The offices also refer senior citizens to these services. You can find the phone number for your local Senior Information and Assistance office on the Department of Aging's web site, or you can call the Maryland Department of Aging at 1-800-AGE-DIAL, weekdays between 8:00 a.m. and 5:00 p.m. Further information.

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