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Medicare: Financial Assistance (QMB, QWDI, SLIMB)

Definition of Net Countable Income

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"Net countable income" for purposes of these programs is determined in the same manner as it is for eligibility for Supplemental Security Income (SSI). This means you can earn (from a job) slightly more than twice the limit and still be eligible.

In calculating income for eligibility purposes, total Social Security Disability Insurance (SSDI) payments are included before deduction for the Medicare Part B premium.

To determine whether income is sufficiently limited ("net countable income"), Social Security "disregards" (deducts):

  • $20 of any income per month; then
  • If you are working, $65 and one half of the remainder of any earned monthly income.
  • If you work, medical expenses paid from your own money to directly support your work attempt are also deducted. For example, if your condition requires that you take a taxi to work instead of public transport, the cost is deducted before determining net countable income.
  • If you are a student and under age 22, another $400 a month is disregarded.
  • If you are blind, work related expenses of any kind not already disregarded are disregarded.

The net effect of the disregards is that a working person can earn a bit more than twice the required level and still qualify.

When a husband and wife share a common household, a spouse's income and assets are deemed to belong to the applicant spouse. This is the case as long as a husband and wife live together in a common household, even if they prove they are not sharing income and assets. If a household is not shared, only actually proven transferred income or assets are counted.

In determining eligibility, so-called "exempt" assets are disregarded, (i.e., they are not counted in determining eligibility). Exempt assets include an automobile to go to and from the doctor, business equity and equipment worth under $6,000 and your lived-in home no matter how valuable. The only residences that qualify are those occupied by applicants, their spouses or their minor or disabled children. Second houses are not included as exempt assets. Also exempted are a separate bank account of up to $1,500 for "burial" and $2,000 cash or cash equivalent.

Generally, the program does not care if an applicant sells assets for less than fair market value or even gives them away in order to qualify for Supplemental Security Income.

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