Medicare Savings Programs

Medicare is extremely important for older adults. It helps with hospital visits, routine care, specialty visits, and prescription drug costs. However, it isn’t free. Medicare, just like any other type of insurance, requires individuals to pay premiums, deductibles, and co-pays. These costs can be a huge financial obstacle for individuals living on fixed incomes. Luckily, there is an option to help individuals pay for Medicare premiums, deductibles, and co-pays. That option is Medicare Savings Programs (MSPs). Here is a brief overview of MSPs.

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.

In order to be eligible for MSPs, you need to have or be eligible for Medicare Part A and meet certain income and asset guidelines. These guidelines vary from state to state. Every state requires that individuals make under a certain amount per year, but that amount varies from state to state. Most states also limit the amount of assets an individual can have, but some states and the District of Columbia have no asset limits. Some items also do not count as assets in any state. These items include, but are not limited to, the house you live in, one car, and household goods.

There are four different types of MSPs. They are Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB) program, Qualifying Individual (QI) program, and Qualified Disabled and Working Individuals (QDWI) program. The QMB, SLBM, and QI programs are all for Medicare beneficiaries. The QDWI program is for individuals who are under 65, are working but have a disabling impairment, have limited income and assets, and aren’t already eligible for Medicaid. These programs have different eligibility requirements and offer different types of financial assistance.

In order to apply for an MSP, you need to call your local Medicaid office or Benefits in Action 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 may 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 from Medicare 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 for premiums paid in a previous calendar year, even if they are otherwise within the 3-month limit. QDWI pays for Part A premiums.

So, there you have it. Medicare doesn’t need to be outside of your budget. You may be eligible for MSP assistance. This will help pay for your Medicare premiums, co-pays, and deductibles. For more information or to see if you qualify, contact Benefits in Action. Their phone number is 720-221-8354 and their email address is info@benefitsinaction.org.


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