Medicare Corner
Medicare Savings Programs Medicare Savings Programs (MSPs), also known as Medicare Buy-In programs, are state programs that assist you with paying your
Medicare costs. The income are the baseline federal income and asset limits for each MSP. There are three main programs, each with different benefits and eligibility requirements:
MSP
Monthly Income Limit
What cost does it cover?
Individual: $0 - $1,153 Couple: $0 - $1,546
• Part A and B premiums • Part A and B cost-sharing (deductibles, copayments, and coinsurances) • Part B premium
Qualified Medicare Beneficiary (QMB)
Individual: $0 - $1,379 Couple: $0 - $1,851
Specified Low-Income Medicare Beneficiary (SLMB) Qualifying Individual (QI)
• Part B premium
Individual: $0 - $1,549 Couple: $0 - $2,080
What other benefits, rights, and protections come with the MSP? If you enroll in an MSP, you will automatically get Extra Help, the
who are in network for your Medicare Advantage Plan cannot bill you for any Medicare cost-sharing. This includes deductibles, copayments, and coinsurances for all Medicare covered services. If you have QMB and your provider bills you for services, let them know that you have QMB and should not be billed. Note that some states may impose small Medicaid copays for certain Medicare-covered services. If you continue to have problems, call your local Senior Medicare Patrol (SMP).
QMB MSP may allow you to enroll in Part A without waiting for the General Enrollment Period, depending on your state. If you have a Late Enrollment Penalty (LEP), the MSP can eliminate it. Most people need this for Part B LEPs. However, if you have a Part A LEP and qualify for QMB, QMB will also eliminate your Part A LEP. If you are enrolled in QMB, providers who accept Original Medicare or
federal program that helps pay your Medicare prescription drug (Part D plan) costs. The MSP allows you to enroll in Medicare outside of the regular enrollment periods. If you missed your Initial Enrollment Period to enroll in Part B, the MSP will allow you to enroll in Part B during any time of the year. If you do not have premium-free Part A and are not enrolled in Part A, the
How can I apply for an MSP? You will need to apply through your local Medicaid office or other state agency that receives MSP applications. Pima Council on Aging is the local State Health Insurance Assistance Program (SHIP) where you can get assistance with your application. Contact the PCOA Medicare department at (520) 546-2011.
Page 6 | June 2022, Never Too Late
Pima Council on Aging
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