2016 key numbers for public benefit programs in Alabama

1. South Central Alabama Development
Commission& Aging&and Disability&Resource&
Center&(ADRC)&
Alabama&Benefit&Checklist&
Assembled&by&Jan&Neal&
Effective 03-01-16
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.&

3. 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&

4. 4&
SSI and Community Medicaid
Benefit Eligibility Standard
SSI Retirement and
Disability
Single Monthly
Income/Resources
$753/$2000
Married Monthly
Income/Resources
$1120/$3000
Medicaid at Home SSI eligibility SSI eligibility
Medicare Buy-In for
Medicare A, B & D
SSI eligibility SSI eligibility
Effective Date/Change Date
01-16/01-17
Institutional Medicaid/Community Medicaid Waiver
Benefit/Penalty Eligibility Standard
Nursing Home
Medicaid
Single Person
Income/Resources
$2199 (with income
over $2199 MQIT
needed)/ $2000
Married Couple
Income/Resource Set
Aside
$2199 (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 01-16/01-17
Married Spousal Resource
Set Aside Standard
07-15/07-16

5. 5&
$119,220
Monthly Spousal
Allotment
$1991 07-15/07-16
Transfer Penalty 1 month for every $5800 transferred 01-16/01-17
Home exclusion Equity at or below $552,000 01-16/01-17
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*
$1010 $1355
SLMB
Pays for:
~Medicare Part B
$1208 $1622
Effective Date/ Change Date
03-16/02-17

6. 6&
premium
QI-1
Pays for:
~Medicare Part B
premium
$1357 $1823
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;
$411 per month
with fewer than 30
qrts.; $226 per
month with 30 – 39
quarters
$1288 per
admission to
hospital during a
spell of illness
$322 per day for
days 61 – 90;
$644 per day for
days 91 – 150
lifetime reserve
Skilled nursing
facility $161 per
day for days 21 -
100
B $104.90 per month
standard premium
if drawing in 2015
(otherwise $121.80)
Premium for higher
income
beneficiaries below
$166.00 20%
Effective
Date/Change Date
01-16/01/17

7. 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 $121.80
Over $85,000 up to
$107,000
Over $170,000 up to
$214,000
N/A $170.50
Over $107,000 up to
$160,000
Over $214,000 up to
$320,000
N/A $243.60
Over $160,000 up to
$214,000
Over $320,000 up to
$428,000
Over $85,000 up to
$129,000
$316.70
Over $214,000 Over $428,000 Over $129,000 389.80
Effective
Date/Change Date
01-16/01/17
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
01-16/01/17

8. 8&
Over $85,000 up to
$107,000
Over $170,000 up to
$214,000
N/A $12.70 + your
plan premium
Over $107,000 up to
$160,000
Over $214,000 up to
$320,000
N/A $32.80 + your
plan premium
Over $160,000 up to
$214,000
Over $320,000 up to
$428,000
Over $85,000 up to
$129,000
$52.80 + your
plan premium
Over $214,000 Over $428,000 Over $129,000 $72.900 + 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” ($34.10 in 2016)
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

9. 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
1010.00/<7280 1356.67/<10,930
Each additional person in the home for whom
applicant provides more than one-half of
person’s support add 346.67
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)
1356.50/<7280 1824.50/<10,930
01-16/01-17

10. 10&
Each additional person in the home for whom
applicant provides more than one-half of
person’s support add 468.00
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
1406.00/<12,120 1891.33/<24,250
Each additional person in the home for whom
applicant provides more than one-half of
person’s support add 485.33
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
$1455.50/<12,140 1958.17/<24,250
Each additional person in the home for whom
applicant provides more than one-half of
person’s support add 502.67
LIS (Partial Subsidy)
C. People eligible for Medicare at or below 150% of
the poverty level with limited resources below (25%

11. 11&
subsidy)
Single
Income/Resources
Married
Income/Resources
Living Together
1505.00/<12,140 2025.00/<24,250
Each additional person in the home for whom
applicant provides more than one-half of
person’s support add 520.00
*Premium State
Standard
$31.32 Effective Date/Change Date
01-16/01-17
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

12. 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
01-16/01-17
Early Retirement Earned Income Offset

13. 13&
Category Based on
NRA
Exempt Amount SS Offset Penalty
Exempt Earnings for
early retirees/workers
whose NRA IS NOT
in 2016
$15,720 Withholding of $1.00 in
benefits for every $2.00
earned over $15,720
Exempt Earnings for
early retirees/workers
whose NRA IS in
2014 and earnings
predated reaching
NRA
$41,880 Withholding of $1.00 in
benefits for every $3.00
earned over $41,880
Effective Date/Change Date
01-16/01-17
SSD Substantial Gainful Activity (SGA)
Category Based on
Disability
Allowable Mo. Earnings
Non-blind $1130.00
Blind $1,820.00
Effective Date/Change Date
01-16/01-17

14. 14&
Alabama Elderly Simplified Application Project (AESAP)
Food Assistance for 60+
Household Size Gross Income Limit Net Income Limit
1 $1276 $981
2 $1726 $1328
3 $2177 $1675
4 $2628 $2021
5 $3078 $2368
6 $3529 $2715
7 $3980 $3061
8 $4430 $3408
Each Additional
Member
$ 451
Effective Date/Change Date
10-1-15/09-30-16
Gift and Estate Tax
Federal Estate Tax
Exemption and Lifetime
exclusion for gifts
$5,450,000 2016/2017
Annual Gift Exclusion $14,000 2016/2017