Medicare Corner
Medicare Cost Assistance Programs Below is information on programs that can help you save on your Medicare costs. To learn more about these programs and receive help with applications, contact your State Health Insurance Assistance Program (SHIP) at 877-2675 or www.shiphelp.org. PCOA is your local SHIP; contact us at (520) 546-2011 .
What are the Medicare Savings Programs? Medicare Savings Programs (MSPs) are state programs that help cover your Medicare costs. To qualify for a MSP, you must meet your state’s income and asset limits. Below are the baseline federal income and asset limits for each MSP. Most states use these limits, but some states have different guidelines, such as different income limits or not imposing asset limits. You should consider applying for the MSP even if you are over the limits, because some income and assets are not counted toward the limits. There are three main programs, each with different benefits and eligibility requirements:
What is Extra Help? Extra Help is a federal program that helps pay for most of the out-of-pocket costs of Medicare prescription drug coverage. If you have Medicaid and MSP or receive Supplemental Security Income, you will be automatically enrolled in Extra Help. If you are not enrolled in these programs, you must apply directly and meet the eligibility requirements below: Income limit Asset limit Benefits
Individual: $1,903 /month Couples: $2,575 /month
Individual: $17,220 Couples: $34,360
$4.50 generic copay $11.20 brand-name copay $0 deductible and premium (for a basic Part D plan with a premium at or below your state benchmark)
MSP
Benefits
Monthly income limit
- Pays Part A and B premiums - Eliminates cost-sharing for Medicare-covered services - Pays Part B premium
Qualified Medicare Beneficiary (QMB)
Individual: $1,275 Couple: $1,724
Medicaid • People can be eligible for both Medicare and Medicaid. • Medicaid can cover services that Medicare does not, like long-term care. • It can also pay secondary to Medicare, picking up Medicare’s out-of-pocket costs, like copayments or coinsurances. • Generally, your income and assets must be below a certain amount to qualify, but this amount varies from state to state and from program to program. • Call your local Medicaid office to learn about Medicaid programs in your state.
Specified Low- income Medicare Beneficiary (SLMB) Qualifying Individual (QI)
Individual: $1,526 Couple: $2,064
- Pays Part B premium
Individual: $1,715 Couple: $2,320
This project was supported in part by grant number 90MPPG0022, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects with government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official ACL policy.
Page 12 | September/October 2024, Never Too Late
Pima Council on Aging
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