Medicare savings program application pdf

This application is only for people who are applying for these benefits medicare savings program application pdf the first time. Please download the application, print it in color, fill it out and return it to the address on the form. If you are not able to print in color, you may use a form printed in black.


The application is several pages long because it screens you for a number of valuable benefit programs. Please note that in order to use PAAD or Senior Gold benefits, you must join a Medicare Part D prescription drug plan if you haven’t done so already unless you are not eligible for Medicare Part D or unless you have other exceptional prescription coverage, known as “creditable coverage. If you have other prescription coverage, please be sure to include a copy of the front and back of prescription coverage card with your application.

If you are eligible for PAAD benefits, you may be screened for a subsidy from the federal government that pays for Medicare Part D premiums, co-insurance, and other out-of-pocket costs. With this subsidy, a person also could qualify for a lower prescription drug copayment than the PAAD copayment. Both SLMB and SLMB QI-1 are Medicare Savings Programs that pay for a person’s monthly Medicare Part B premium. 100 reimbursement for the purchase of a hearing aid.

In addition, if you are eligible for PAAD benefits, you may also be eligible for other benefits, such as reduced motor vehicle fees, discounted prices for spaying or neutering your cat or dog, and the property tax freeze. Programs are multiple programs for people who need help in the community or with long-term services and supports. Information on all the ABD Programs is provided in the Brochure. In determining whether a person is financially eligible, the applicant’s financial eligibility will be considered along with his or her spouse or parents.

Click here to see what you may need in order to apply. In some cases, low-income Medicare recipients may also qualify for New Jersey Medicaid, which will provide them with assistance in paying their monthly Medicare premiums, co-pays and deductibles. For information about the income eligibility requirements of this program, call 1-800-792-9745.