Medicare Savings Plans Update

Are you transitioning from Medicaid to Medicare? Have you noticed a deduction of approximately $170.10 from your Social Security check for your Medicare premiums? Are you unable to afford your Medicare deductibles and co-pays? Do you live on a fixed income and have little to no assets? If so, you may be eligible for a Medicare Savings Plan (MSP). This article aims to discuss MSPs and the eligibility requirements for them, so you can make an informed decision about whether to try to obtain one.

MSPs are programs designed to help individuals pay for their Medicare costs if they have limited income and assets. They help individuals pay for the out-of-pocket expenses associated with Medicare Part A and Part B plans. Individuals who qualify for MSPs are also automatically enrolled in the Medicare Part D Extra Help program (also known as the low-income subsidy), which helps pay for Part D prescription drug costs. However, MSPs do not cover the costs associated with Medicare Part C (Medicare Advantage) plans.

Colorado offers four different MSP programs, which offer different benefits. These MSPs are the Qualified Medicare Beneficiary (QMB) program, Specified Low-Income Medicare Beneficiary (SLMB) program, Qualifying Individual (QI) program, and Qualified Disabled and Working Individuals (QDWI) program. To be eligible for one of those MSPs, you need to have or be eligible for Medicare Part A and meet certain income and asset guidelines. The income and asset guidelines are as follows:

Program Income Limit Before Taxes Resource Limit
QMB $1,153 a month individual income
$1,546 a month couple income
$9,900 individual resources
$15,960 couple resources
SLMB $1,379 a month individual income
$1,851 a month couple income
$9,900 individual resources
$15,960 couple resources
QI-1 $1,549 a month individual income
$2,080 a month couple income
$9,900 individual resources
$15,960 couple resources
QDWI $2,285 a month individual income
$3,072 a month couple income
$4,000 individual resources
$6,000 couple resources

You might be looking at this chart with some questions. If so, here are some answers. The income limits are based on gross income and vary based on whether you live alone or with your spouse. The higher income limits in the chart represent income limits for married couples. Additionally, not everything that you own counts as a resource. For example, resources include items such as money in a checking or savings account, stocks, bonds, IRAs, trusts, and retirement accounts, but do not include the house you live in, one car, and your furniture or other personal possessions.

To apply for an MSP, call Benefits in Action or your county Medicaid office for application guidelines. This is because MSPs, despite offering help with Medicare premiums, are run by Medicaid. You will also have to provide a variety of documents at the time you apply for an MSP. These documents include your social security card, your Medicare card, your birth certificate, passport, or green card; proof of your address; proof of your income; and information about your assets. Once you apply, you will receive notification within 45 days telling you whether your application was approved or denied.

Depending on which MSP you receive, you will receive different types of financial assistance. QMB helps individuals pay monthly premiums for Medicare Part A and B, as well as the Part B annual deductible and co-pays. SLMB and QI pay for Part B premiums and offer up to 3 months retroactive reimbursement for previously paid Part B premiums. However, the QI program doesn’t reimburse premiums paid in a previous calendar year, even if they are otherwise within the 3-month limit. QDWI pays for Part A premiums.

Medicare does not need to be outside of your budget. You may be eligible for an MSP. This could help pay for your Medicare premiums, co-pays, and deductibles. For more information or to see if you qualify, you can contact Benefits in Action at 720-221-8354 or via email at info@benefitsinaction.org.

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