What is a Medicare Savings Program?

Medicare Savings Programs (MSP’s) are federally funded programs that help people on Medicare who have limited income and resources pay for their Medicare costs.

The individual state Medicaid offices administer the Medicare Savings Programs.

Benefits Of MSP’s

The programs can help pay for deductibles, coinsurance, and co payments associated with out of pocket costs for Medicare services. When you’re retired and on a low, fixed income, every dollar counts.

If you don’t qualify for full Medicaid, you still may be eligible for a Medicare Savings Program.

Most people don’t pay anything for Medicare Part A. For Part B, there’s a monthly premium. Many people get assistance paying for their Part B from a Medicare Savings Program.

Medicare Savings Program And Extra Help With Part D

Being eligible for a Medicare Savings Program automatically qualifies you for Medicare Part D Extra Help.

Extra Help, or Medicare Part D Low Income Subsidy, provides reduced costs for prescription medications to Medicare beneficiaries that have income and resources below certain qualifying levels.

When you get Extra Help, you avoid the Part D late enrollment penalty. And without Extra Help, the penalty applies if you didn’t enroll in a drug plan when you were first eligible.

Qualifying For A Medicare Savings Program

In order to apply for the Medicare Savings Program, you must meet the following criteria:

• You must already have or be eligible for Medicare Part A
• Your income must be at or below the Federal or state limits for the specific program
• Your resources need to be below the Federal or state limits where you reside

Resources Counted With The Savings Programs

The resources that are counted in the Medicare Savings program resource limits are:

• Money in checking or savings accounts
• Stocks
• Bonds

The resources that are NOT counted are:

• Your primary residence
• One car
• Burial plot
• Money for your Burial expenses up to $1500
• Furniture
• Household and personal items

Types Of Medicare Savings Programs

There are 4 types of Medicare Savings Programs with each having a qualifying level of income and resource limits.

The guidelines are state specific, and the limits can vary from state to state. Some states don’t have limits on the amount of your resources or assets you can have.

1. Qualified Medicare Beneficiary (QMB)
2. Specified Low Income Medicare Beneficiary (SLMB)
3. Qualifying Individual (QI)
4. Qualified Disabled Working Individual (QDWI)

It’s important to mention that these limits can go up every year.  Therefore, you’re encouraged to apply, even if your income and resources are slightly higher than the amounts listed.

Reach out to us at (800) 783-5901 or email info@usamedicareplan.com if you have any questions on your states specific guidelines.

Qualifying Limits Of MSP’s

Let’s talk briefly about each Medicare Savings program and the qualifying limits for the current year (2020).

The limits mentioned are Federal limits directly from the Medicaid government website. It’s important to note – each states income and asset limits can vary.

Alaska and Hawaii have higher limits for all the programs we’re going to talk about.

QMB

1) The first category type of MSP is the Qualified Medicare Beneficiary or QMB.

The monthly income limits in 2020 for an individual is $1084 and for a couple $1457.

The asset limits are $7860 for an Individual and $11800 for couples.

The benefits for QMB Include coverage for the Part A deductible, Part A premium, and hospital co-pays. Coverage also includes Skilled Nursing facility co-pays, the Part B monthly premium, Part B deductible, and Part B 20% coinsurance.

You won’t get a bill for any services that medicare covers, except for Part D prescription drugs. You’ll have reduced co-pays through the Extra Help with Part D program.

SLMB

2) The next category of MSP is the Specified Low-Income Medicare Beneficiary or SLMB.

The monthly income limits in 2020 for an individual is $1296 and for a couple $1744.

The asset limits are $7860 for an Individual and $11800 for couples.

The benefit for SLMB includes coverage for the Part B monthly premium.

If you receive Social Security benefits, this amount would be deducted from your Social Security check every month. If you qualify for the SLMB program, the Part B premium would be paid by the government.

QI

3) The third type of MSP is the Qualifying Individual or QI.

The monthly income limits in 2020 for an individual is $1456 and for a couple $1960.

The asset limits are $7860 for an Individual and $11800 for couples.

The benefit for Qualifying Individuals includes coverage for the Part B monthly premium only. With this program you have to re-apply every year and it’s available on a first come first serve basis.

QDWI

4) The fourth type of MSP is the Qualified Disabled Working Individual or QDWI.

The monthly income limits in 2020 for an individual is $4339 and for a couple $5833.

The asset limits are $4000 for an Individual and $6000 for couples.

The benefits for QDWI help pay the Medicare Part A premium. You may be eligible if you’re under age 65, disabled, and working with limited income and resources.

 

If you can’t afford the Medicare Part B premium, a Medicare Savings Program can be a great way to put more money back in your pocket every month.

We specialize in saving our clients money and we can help you save too! Our service is 100% FREE and we’re happy to help you.

If you have questions on any of the Plans or programs, then give us a Call at (800) 783-5901 or Email us at Info@usamedicareplan.com.