Federal Poverty Level Benefits Checklist for Seniors
📋 Federal Poverty Level Benefits Checklist
Income Calculation Worksheet
Written & Reviewed by
Monthly Income Sources:
- Social Security: $
- Pension/Retirement: $
- Part-time work: $
- Investment income: $
- Other income: $
Total Monthly Income: $
Calculate Your FPL Percentage:
1. Annual Income: $ (Monthly × 12)
2. Your FPL %: % (Annual Income ÷ $15,650 × 100)
2025 FPL Quick Reference
- 100% FPL: $15,650 annually ($1,304 monthly)
- 120% FPL: $18,780 annually ($1,565 monthly)
- 130% FPL: $20,345 annually ($1,695 monthly)
- 135% FPL: $21,128 annually ($1,761 monthly)
- 150% FPL: $23,475 annually ($1,956 monthly)
Check all programs you may qualify for:
- QMB - Income under 100% FPL + assets under $9,660 (single)
- SLMB - Income 100-120% FPL + assets under $9,660 (single)
- QI - Income 120-135% FPL + assets under $9,660 (single)
- QDWI - Under 65, disabled, working, income under 200% FPL
Remember: All MSPs include $20 monthly income disregard
- SNAP - Income under 130% FPL + assets under $2,750 (60+)
- Senior Farmers Market - Income under 185% FPL
- Commodity Foods - Income under 130% FPL
- Medicaid - Varies by state (100% FPL to 138% FPL)
- Part D Extra Help - Income under 150% FPL + assets under $16,660
- State Pharmacy Programs - Varies by state
- LIHEAP - Usually 150% FPL (varies by state)
- Weatherization - Usually 200% FPL
- HUD Housing Choice Voucher - Usually 50% FPL
- Public Housing - Usually 80% FPL
Gather these documents BEFORE applying:
- Social Security award letter (get from my.ssa.gov)
- Pension statements (last 3 months)
- Bank statements (last 3 months)
- Pay stubs if working part-time
- Tax return (most recent)
- Bank account statements (all accounts)
- Investment account statements
- Vehicle registration/title
- Life insurance policies (cash value statements)
- Property tax statements
- Medicare card (Parts A & B)
- Medicare supplement insurance cards
- Current prescription list with costs
- Medical expense receipts (last 3 months)
- Rent receipt or mortgage statement
- Utility bills (electric, gas, water, phone)
- Property tax bills
- Homeowner's/renter's insurance
- Photo ID (driver's license or state ID)
- Social Security card
- Birth certificate (if needed)
- Citizenship/immigration documents (if applicable)
Week 1: Medicare Savings Programs
- Contact: Your state Medicaid office
- Application method: Online, phone, or in-person
- Timeline: 30-45 days for decision
- Why first: Often triggers automatic eligibility for other programs
Week 2: SNAP Benefits
- Contact: Your state SNAP office
- Application method: Online at your state's website
- Timeline: 30 days (7 days for emergency if qualifying)
- Special: Mention you're 60+ for simplified application
Week 3: Medicaid (if not automatic)
- Contact: State Medicaid office
- Application method: Often same as MSP application
- Timeline: 45-90 days
- Note: May be automatic if you get QMB
Week 4: Additional Programs
- Part D Extra Help: Apply at ssa.gov
- LIHEAP: Contact your local energy assistance office
- Local food banks: Find at feedingamerica.org
Essential Phone Numbers
Write your local numbers here:
State Medicaid Office:
SNAP Office:
SHIP Counselor:
Area Agency on Aging:
211 (General Help): Just dial 2-1-1
Eldercare Locator: 1-800-677-1116
National Numbers
Medicare: 1-800-MEDICARE
Social Security: 1-800-772-1213
Crisis Helpline: 988
SHIP Help: shiphelp.org
Benefits Finder: benefits.gov
| Program | Application Date | Decision Due | Result | Monthly Benefit | Renewal Date |
|---|---|---|---|---|---|
| Medicare Savings Program | $ | ||||
| SNAP Benefits | $ | ||||
| Medicaid | $ | ||||
| Part D Extra Help | $ | ||||
| LIHEAP | $ | ||||
| Other: | $ |
Before Applying
- DON'T assume you don't qualify - Apply even if you're not sure
- DON'T forget the $20 income disregard for Medicare Savings Programs
- DON'T count excluded assets (home, one car, burial funds)
- DON'T apply for just one program - Most seniors qualify for multiple
During Application Process
- DON'T miss deadlines - Mark your calendar for response dates
- DON'T provide incomplete information - Answer every question
- DON'T throw away any paperwork - Keep copies of everything
- DON'T pay application fees - Legitimate programs are always free
If Denied
- DON'T give up - Many denials are due to paperwork errors
- DO appeal within deadlines (usually 60-90 days)
- DO get help - Contact legal aid or SHIP counselors
- DO reapply if your situation changes
Food Emergency
- Call 211 for local food banks
- Visit findhelp.org for immediate assistance
- Contact Salvation Army:
- Contact local churches/community centers
Utility Shut-off Prevention
- Call your utility company's customer service immediately
- Ask about emergency assistance programs
- Contact LIHEAP office:
- Contact local community action agency:
Medical Emergency/Can't Afford Medications
- Contact prescription assistance programs: needymeds.org
- Call pharmaceutical companies directly for patient assistance
- Contact local community health centers
- Ask your doctor about samples or generic alternatives
Housing Crisis
- Contact HUD housing counseling: Call 211
- Contact local homeless prevention services
- Contact Area Agency on Aging:
Set These Reminders in Your Phone/Calendar
January:
- New FPL guidelines released by HHS
- Check if any programs expanded eligibility
March/April:
- Many states implement new FPL guidelines
- Medicare Savings Program income limits may update
October:
- Medicare Open Enrollment (Part D plans)
- Review Part D Extra Help if you have it
November:
- Start gathering documents for any redeterminations
Monthly:
- Check for renewal notices (usually come 60-90 days early)
- Report any income changes within 10 days
Personal Redetermination Dates
Write your specific dates here:
Medicare Savings Program:
SNAP Benefits:
Medicaid:
Part D Extra Help:
Other:
Monthly Benefits Tracking
Keep track of how much these programs save you:
Medicare Savings Program:
Part B premium saved: $ /month
Deductibles/copays saved: $ /month
SNAP Benefits:
Monthly food assistance: $ /month
Part D Extra Help:
Prescription savings: $ /month
Medicaid:
Medical expenses covered: $ /month
LIHEAP:
Utility assistance: $ /year ÷ 12 = $ /month
Total Monthly Value: $ /month
Total Annual Value: $ /year
This is money staying in your pocket for other necessities!
Government Offices
State Medicaid Office:
SNAP/Food Stamps:
Social Security Office:
Medicare: 1-800-MEDICARE (1-800-633-4227)
Free Help Resources
SHIP (Medicare Help):
Area Agency on Aging:
Legal Aid:
Benefits Enrollment Center:
Healthcare
Primary Doctor:
Pharmacy:
Insurance Agent:
Emergency
211 (Dial 2-1-1): General resource help
Eldercare Locator: 1-800-677-1116
Crisis Line: 988 (Suicide & Crisis Lifeline)
- I calculated my FPL percentage: %
- I identified all programs I may qualify for
- I gathered all required documents
- I have contact information for local offices
- I set up my application tracking system
- I marked renewal dates in my calendar
- I shared this information with family/trusted friends
- I contacted a SHIP counselor for free help
🎯 Remember: You've Earned These Benefits
- ✅ These programs exist because you paid taxes during your working years
- ✅ Applying for help is not shameful - it's smart financial planning
- ✅ Free professional help is available in every community
- ✅ Millions of seniors successfully use these programs every year
- ✅ You deserve to live with dignity and financial security
Most Important: Don't let another month pass without exploring programs you may qualify for. The application you submit today could improve your financial security tomorrow.
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