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Malti Patel

Q. What are the income and resource requirements for the extra help with prescription drug costs?

A. If you are single and your annual income is below $14,700 (or $19,800 if you are married and living with your spouse), you may qualify for the extra help. Even if your annual income is higher, you still may be able to get some help. Some examples when your income may be higher include if you or your spouse:

" Support other family members who live with you;

" Have earnings from work; or

" Live in Alaska or Hawaii.

To get the extra help with Medicare prescription drug plan costs, your total resources generally must be limited to $11,700 as single (or $23,410 if you are married and living with your spouse).

Resources include the value of the things you own. Some examples are:

" Real estate (other than your primary residence);

" Bank accounts, including checking, savings and certificates of deposit;

" Stocks;

" Bonds, including U.S. savings bonds;

" Mutual funds;

" Individual Retirement Accounts (IRAs); or

" Cash at home or anywhere else.

Q. How do I obtain a copy of the form, Application for Help with Medicare Prescription Drug Plan Costs, SSA-1020?

A. If you just want to see the application form, you can view a sample at Instruction sheets are available in 15 different languages to help you understand the application.

If you wish to apply for help with Medicare prescription drug costs, you can use online application at

If you prefer not to fill out this application on the Internet, you can call 1-800-772-1213 for a paper application or to make an appointment for application. If you are deaf or hard of hearing, call number 1-800-325-0778.

Representatives are available from 7 a.m. to 7 p.m. Monday through Friday. Tell the representative that you want to apply for help with Medicare prescription drug costs.

Q. How and where can I apply for the extra help for the prescription drug program?

A. You have several options for applying. You can:

" Apply online.

" Complete the application mailed to you by Medicare and return it in the postage-paid envelope.

" Call 1-800-772-1213 if you did not receive an application and think you may be eligible. They will mail you a form or help you on the phone to complete the application.

" Look for information about Social Security events or meetings in your local community that will discuss the prescription drug program, and attend one of them. We will help you apply at the event.

" Visit your local Social security office

Q. When can I sign up for my Medicare drug coverage?

A. If you are newly entitled or enrolled in Medicare, you may enroll during your initial enrollment period for Medicare. If you do not join during this period, your next chance to join will be during the annual coordinated election period (AEP) between Nov. 15 and Dec. 31 each year. There also will be special enrollments periods (SEPs) if you lose your employer-based coverage, move from your prescription drug provider's (PDP) or Medicare-Advantage Plan that offers prescription drug coverage (MA-PD) service area and when a provider goes out of business or is decertified by Medicare.

For assistance in selecting a plan and enrolling, go the, a Web site of the Center for Medicare and Medicaid Services (CMS).

Q. I no longer need Medicare Part B because I am covered by other health insurance. How do I disenroll?

A. If you wish to disenroll from Medicare Part B, you will need to submit form CMS-1763 to the Social Security Administration. The form is used to voluntarily terminate entitlement to Supplementary Medical Insurance (Part B) and Premium hospital Insurance and is owned by the Center for Medicare and Medicaid Services (CMS).

CMS requires that a personal interview be conducted with every individual who wishes to terminate entitlement and so they do not offer form CMS-1763 on the public Internet site. The form will be completed during an in-person or phone interview so as to ensure that the beneficiary understands the ramifications of termination.

After the interview, our Social Security Administration representative is required to provide you with a letter outlining the consequences of voluntary termination and of the right to withdraw the termination request before coverage ends. Disenrolling is a serious decision; if you wish to reenroll later, you may have to pay a surcharge.

Termination of Medicare Part B will be effective at the end of the month following the month in which the termination request is filed.

For an interview, call 1-800-772-1213 or contact your local Social Security office.

Q. If I apply for the extra help and am approved, will I automatically be enrolled in a prescription drug plan?

A. Only if you do not enroll on your own. If you do not enroll on your own, the Centers for Medicare & Medicaid Services will send you a letter in May 2006 that will tell you which plan you have been enrolled in and how to change plans. However, you could lose months of benefits and you may not get the plan that is best for you if you wait to be automatically enrolled.

Q. If I call 1-800-772-1213, can a Social Security representative take my application for Medicare prescription drug help over the phone?

A. When you call the 800 number, if an interviewer is available, he or she can take your application over the phone. If an interviewer is not immediately available, we will schedule a telephone appointment for you. For faster service, you can apply at

Q. Is there a time limit when I can apply for the extra help with prescription drug plans?

A. You can apply any time, but you should apply as early as possible so you will know what assistance you can receive.

Q. The application that I received in the mail indicates that the resource limits are $11,710 for singles and $23,410 for married couples. But I have heard elsewhere that the resource limits are $10,210 for singles and $20,410 for married couples living together. I am confused; what are the actual resource limits?

A. The limits are $10,210 for singles and $20,410 for couples. But the resource limits shown on the application include a $1,500 per person exclusion for burial purposes. So, if you expect to use some of your resources to pay for burial or funeral expenses, your resource limit is $11,710 if you are single or $23,410 if you are married and living with your spouse.

These questions and answers are courtesy of Malti Patel, 1607 Wood Creek Lane, Allen, Texas-75002. Patel published a book "Lifting the Mists: A simple guide to a complex welfare system for elderly immigrants and their families." Email to order the book.

Ramesh Parekh

As many people know, Long Term Care (LTC) cost could be high and is escalating at a high rate. Lack of a Long Term Care Insurance (LTCI) protection can wipe out all net worth of many senior citizens. Some important and basic knowledge on LTC policy:

1. Selection of insurance company:

Financial strength - It is important to select a company with good financial strength so that it may be around for a long time when your claim may arise. There are independent agencies that rate insurance companies based on their financial strength such as A.M. Best.

Experience - Select a company with long and good record of payments of claims and customer care. Such an experienced company will generally have a better knowledge in premium rate setting and claim payments.

2. The policy :

LTC policies are quite complex in terms of coverage, options, exclusions and limitation. LTCI policies vary tremendously. Here are some aspects of policy you will need to consider:

Deductible - Elimination period - Could be 20, 30, 90, 120 days or longer period during which you must pay for nursing-home care out of your own pocket. The longer the elimination period, the lower the premium.


How are long-term home care expenses covered? Will the policy pay a relative for the home care?

Does elimination period apply to home care?

Is there a waiver of premium during the care? When does the waiver clause start?

Does the policy pay less benefits for home care or assisted living facility than nursing home stays?

What are the exclusions and limitations in benefit coverage? How much coverage will you have? What will be daily/weekly/monthly and total benefit limits?

Is there an automatic inflation protection rider?

Is the inflation adjustments "simple" or "compound"?

Most states require companies to offer inflation protection. It is up to you to decide whether to buy that coverage.

You have to select the number of years for the benefit period. Insurers do offer lifetime coverage but the premiums can become unaffordable. Usually, the benefit period of 3-6 years is adequate.

3. Pricing :

Make sure that you can afford a premium without affecting your lifestyle or depleting your assets even if the premiums go up in future.

Most of the policies reserve the company's right to increase the premium in future.

Inquire about the past rate increases of the company.

Check out if there is a spousal discount for spouse/partner coverage

The decision to buy the LTC insurance is an important financial decision and lifetime commitment.

There are many experts in the field. I believe your best help will probably come from an insurance representative who specializes in long-term care insurance. A trusted insurance professional can help you in guiding through the maize of information on insurance companies, policy selections and help you determine what suits your needs the best.

For those who want to make decisions on your own, there are resources available. Shopper's Guide to Long-Term Care by National Association of Insurance Commissioners at or contact Florida Department of Insurance at

Ramesh Parekh, CPA, can be reached at (727) 461-9770 or e-mail or

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