Mc14a 2025

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The document is an application form for the Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individuals (QI) programs in California. It outlines eligibility criteria, including income limits and property restrictions, for individuals seeking assistance with Medicare premiums and costs. The form requires personal information, income details, and household composition to determine eligibility for these programs.

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Click ‘Get Form’ to open the mc14a in the editor.
Begin by filling in your personal information, including your name, social security number, and date of birth. Ensure accuracy as this data is crucial for eligibility.
Indicate your marital status by selecting the appropriate checkbox. This helps determine your income limits for QMB, SLMB, or QI programs.
In Section A, provide details about your countable income. Fill in the monthly amounts for various sources of unearned income such as Social Security checks and VA benefits.
If applicable, complete the spouse's income section. Add all relevant figures to calculate total earned and unearned income accurately.
Proceed to Section B to list your countable property values. Remember that certain assets like your primary home do not count towards limits.
Review all entries for completeness and accuracy before submitting. Once satisfied, save and send the completed form directly from our platform.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the difference between full Medicaid and QMB?

Starting January 1, 2024, the asset test to qualify for a Medicare Savings Program was eliminated. This means individuals can have any amount of assets and still qualify for a Medicare Savings Program. Assets are things that you own, such as bank accounts, cash, second homes and vehicles.

Does Medicare look at your savings account?

Medicare examines your bank accounts and other assets when you seek financial help with Medicare costs. However, eligibility criteria and verification procedures differ by state of residence. In certain states, there are no asset limits for Medicare savings programs.

Can you lose Medicare if you have too much money?

There are no income limits to receive Medicare benefits, but you may pay more for your premiums based on your level of income. If you have limited income, you might qualify for assistance in paying Medicare premiums.

How much money can you have in the bank and still get Medicare?

Medi-Cal Programs Qualification at a Glance 2024 Asset limits are eliminated for all programs except SSI as of January 1, 2024. SSI asset limits are: Single: $2,000; Couple: $3,000 Program / Requirements Your Monthly Income4 more rows

What assets can you keep when you go on Medicare?

These include: Your primary house. One car. Household goods and wedding/engagement rings. Burial spaces. Burial funds up to $1,500 per person. Life insurance with a cash value of less than $1,500.