Birdseye Financial
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2021 United Health Care Dual Complete (HMO D-SNP) Plan
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What is Medicaid?
Enacted in 1965 through amendments to the Social Security Act, Medicaid is a health and long-term care coverage program that is jointly financed by states and the federal government. Each state establishes and administers its own Medicaid program and determines the type, amount, duration, and scope of services covered within broad federal guidelines. States must cover certain mandatory benefits and may choose to provide other optional benefits.

Federal law also requires states to cover certain mandatory eligibility groups, including qualified parents, children, and pregnant women with low income, as well as older adults and people with disabilities with low income. States have the flexibility to cover other optional eligibility groups and set eligibility criteria within the federal standards. The Affordable Care Act of 2010 creates a new national Medicaid minimum eligibility level that covers most Americans with household income up to 133 percent of the federal poverty level. This new eligibility requirement is effective January 1, 2014, but states may choose to expand coverage before this date.

The Children’s Health Insurance Program (CHIP) was created in 1997 through an amendment to the Social Security Act to provide health care coverage to low-income children not already eligible for Medicaid. Like Medicaid, CHIP is jointly financed by states and the federal government. States have the option of using CHIP funds to expand their existing Medicaid program, create a separate stand-alone CHIP, or do a combination of both.
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Medicaid and LOW INCOME SUBSIDY (LIS)
  • Medicare Website
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  • Insurance Commissioner of WA
  • Medicare Dual Complete Qualifications (Download PDF)
  • Need Help Paying for Medication (LIS)?
  • Additional Resource from E-health (LIS)?
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Categories of dual eligible beneficiaries and out-of-pocket costs that must be paid by Medicaid:
  • QMB (only) (Qualified Medicare Beneficiary) – Medicare Part A and Part B premiums; cost sharing for Part A & Part B benefits.
  • QMB Plus – Medicare Part A and Part B premiums; cost sharing for Part A & Part B benefits; Full Medicaid benefits.
  • SLMB (only) (Specified Low-Income Medicare Beneficiary) – Medicare Part B premium.
  • SLMB Plus – Medicare Part B premium; Full Medicaid benefits.
  • QI (Qualifying Individual) – Medicare Part B premium.
  • Other FBDE (Full Benefit Dual Eligible) – Medicare Part B premium; Full Medicaid benefits.
  • QDWI (Qualified Disabled & Working Individual) – Part A premium.

*** This information may change. We are supplying this information for educational purposes. Please contact the agency that handles assistance for the most up to date details.
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BIRDSEYE FINANCIAL DISCLOSURE
Tax and Legal Disclosure

Birdseye Financial, Corbin Lindsey and any associate affiliated with Birdseye Financial, does not offer tax or legal advice. We provide strategies for educational purposes only. You should consult your tax or legal professional for complete information regarding any tax and legal matters.

Website Content
The information listed on this website and on any document from Birdseye Financial that is provided by Birdseye or by a third party has been obtained from sources believed to be reliable, but accuracy and completeness cannot be guaranteed by Birdseye Financial. While the publisher has been diligent in attempting to provide accurate information, the accuracy of the information cannot be guaranteed. Laws and regulations change frequently, and are subject to differing legal interpretations. Accordingly, neither the publisher nor any of its licensees or their distributors shall be liable for any loss or damage caused, or alleged to have been caused, by the use or reliance upon this information.

All items on this website are not to be considered a recommendation to purchase or to sell an insurance or investment holding. No insurance company has endorsed or reviewed this website content. Before purchasing any type of insurance and/or investment product, it is important that you do your own due diligence, and that you consult a properly licensed professional if you should have any specific questions that relate to your individual situation. All of the names, marks, and materials that were used within this website are the property of their respective owners.

We are NOT affiliated with the U.S. Government or Federal Medicare Program

Product Illustrations
​And as always, it’s important to keep in mind that past performance is definitely no guarantee of the future results that you’ll receive in most any financial vehicle.

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​Should you complete an online form of any type, you are agreeing to be contacted by Birdseye Financial or one of our referral partners.
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