This document provides information on various public benefits programs in Alabama including:
- Medicaid eligibility and income/resource limits for SSI, institutional care, and home and community-based waivers.
- Medicare Savings Programs eligibility and premium subsidies.
- Medicare Part A, B, and D premiums, deductibles, and cost sharing amounts.
- Social Security retirement ages and benefit reductions for early retirement.
- Low Income Subsidy ("Extra Help") eligibility and subsidy levels for Medicare Part D prescription drugs.
- Alabama food assistance program limits.
- Federal estate and gift tax exemptions.
4. 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
5. 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
6. 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
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 $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
8. 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
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
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
10. 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%
11. 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
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
01-13/01-14
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 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
14. 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