Medicare Savings Program FI

Medicare Savings Program

What Is The Medicare Savings Program

The Medicare Savings Program is a federally funded program to help seniors cover health care costs not included in Medicare. It vastly reduces uncovered Medicare health care costs (for life) and can make a huge difference for you financially. It is one of the most useful and important benefits you can obtain as a senior. There is some paperwork involved but it is worth doing to have your out-of-pocket Medicare health care costs reduced or removed.

The Medicare Savings Program can eliminate what can turn into a very stressful reduction of a senior’s Social Security check by hundreds of dollars every month. Annually, it can anchor $1,600.00 or more in your bank account from Medicare premium savings alone. Deductibles and coinsurance costs that erode up to thousands a year can also be controlled with this program. It is vital for every senior to know about it and try to qualify.

If a savings of thousands of dollars in health care costs sounds like something that might be useful to you, take advantage of the Medicare Savings Program, a federally funded boon to all seniors and one of the most impactful senior benefits available to improve your financial situation long-term.

What does The Medicare Savings Program cover?

The Medicare Savings Program benefits are available to seniors and some are also available to disabled working individuals under 65. The benefits will pay all or part of your Medicare premiums. This includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles, co-payments and co-insurance. These benefits can leave you with minimal or zero cost out-of-pocket.

How To Get Approved For The Medicare Savings Program

Approval is based on financial resources, specifically, income and assets. It helps to be in the know about what resources need to be included,  but also what items can be excluded.  The qualifying limits are not fixed. They differ by state and change annually as well. There are four different Medicare Savings Programs; QMB, SLMB,  QI and QI-1, and QDWI. Each one has different income/resource limits and coverage of your Medicare costs.

  1. QMB limits are as follows: Individual income limit $1,032.00/Couple $1,392.00. Individual resource limit: $7,560.00/Couple $11,340.00. This program covers Part A and Part B premiums, all deductibles, coinsurance and copayments.
  2. SLMB limits are as follows: Individual income limit $1,234.00/Couple $1,666.00. The resource limits are the same as QMB.  It covers only Part B premiums, but that still can save thousands each year.
  3. QI limits are as follows: Individual income limit $1,386/Couple $1,872.00. The resource limits are the same as QMB. It also only covers Part B premiums, but allows for higher income limits.
  4. QDWI limits are as follows: Individual income limit $4,132.00/Couple $5,572.00. Resource limits are higher, with individual resource limits at $4,000.00/Couple $6,000.00. This program will pay for your Part A premiums.

Countable resources you will need to disclose are: checking/savings accounts, stocks and bonds. Even if your resources are slightly higher that the limits listed, go ahead and apply anyway.

You do not need to count your house, one car, burial plots and up to $1,500.00 in burial expenses if they have been earmarked for that purpose, furniture, household and personal possessions.

Medicare Savings Program Application

To apply for the Medicare Savings Program go to https://www.medicare.gov/Contacts/#resources/msps and follow the link to the Medicaid department of your specific state.

Medicare Savings Program vs. Medicare Extra Help

If you qualify for QMB, SLMB or QI, you will also qualify for Medicare Extra Help which will pay for your Medicare prescription costs. It could mean you pay nothing at all for your prescription, or only a small amount such as $3.70 in 2018. Please note that Medicare does not automatically cover all drugs, and there are some not included in their approved drug formulary.

If you are a senior and do not qualify for any of these programs, Medicare assumes, rightly or not, that you can afford to pay your premiums, copays and deductibles. You can obtain gap insurance coverage and/or use a prescription discount card which can save you up to 80% on the cost of your medications. You can also qualify for Prescription Advocacy Programs.


Medicare Savings Program Renewals

Please note that you need to re-apply annually for the Medicare Savings Program or you will lose the benefits. Miss the re-qualifying cut-off date and you’ll be seeing copays and deductibles just as before.

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