The Medicare program was formed to be an affordable, comprehensive medical insurance option for seniors and other qualifying Americans. Unfortunately, life isn’t always that simple. If you find yourself in a situation where you could use extra help with Medicare, you’re in luck, because you’ve got several options. One such option is a Medicare Savings Program.
The Basics of Medicare Savings Programs
A Medicare Savings Program is a combination of two incredibly popular federal programs, Medicare and Medicaid. In a Medicare Savings Program (MSP), Medicaid assists beneficiaries with limited income or resources with some or all Medicare premiums, deductibles, or coinsurances. These programs are also sometimes known as Medicare Buy-In or Medicare Premium Payment Programs. If you qualify and enroll in an MSP, you’ll also get Extra Help automatically, which helps with Medicare Part D costs.
In a Medicare Savings Program (MSP), Medicaid assists beneficiaries with limited income or resources with some or all Medicare premiums, deductibles, or coinsurances.
Regardless of which kind of MSP you’re looking to enroll in, you must have Medicare Part A and match the individual state’s income and asset limits. Generally, incomes and assets that are counted toward the limit include monies in your checking and savings accounts, stocks, and bonds. Resources not included are homes, a burial plot, furniture, or household/personal items. Some things are not counted up to a point, like cars (which aren’t counted until you have more than one) or burial expenses up to $1,500. To learn more about your state’s specific limits, contact your local Medicaid office or your State Health Insurance Assistance Program.
The Four Different Types
If an MSP is an avenue you’d like to explore, you’ll have four different programs to look into. Each covers different Medicare-approved costs and has differing base requirements for enrollment.
The Qualified Medicare Beneficiary Program
The most comprehensive of these is perhaps the Qualified Medicare Beneficiary (QMB) program. The QMB program pays for your Original Medicare premiums and also covers deductibles, coinsurance, and copayments. In 2019, the standard limits for QMB are:
- Monthly individual income limit: $1,061
- Annual individual resource limit: $7,730
- Monthly married couple income limit: $1,430
- Annual married couple resource limit: $11,600
Specific Low-Income Medicare Beneficiary Program
Alternatively, the Specified Low-Income Medicare Beneficiary (SLMB) program is available to assist with Medicare Part B premiums. Since it covers less, the program has higher limits on who can enroll, making it more readily available to individual seniors. The SLMB can be helpful for seniors with premium-free Medicare Part A, especially. In 2019, the standard limits for SLMB are:
- Monthly individual income limit: $1,269
- Annual individual resource limit: $7,730
- Monthly married couple income limit: $1,711
- Annual married couple resource limit: $11,600
Qualifying Individual Program
Similar to the SLMB program, the Qualifying Individual (QI) program covers Part B premiums only. One difference is that you must reapply for the benefits each year and are granted on a first-come, first-served basis, though preference is given to those who were enrolled the previous year. Similar to the previous programs, the annual resource limits remain the same, though the monthly limits are slightly higher. In 2019, the QI standard limits are:
- Monthly individual income limit: $1,426
- Annual individual resource limit: $7,730
- Monthly married couple income limit: $1,923
- Annual married couple resource limit: $11,600
Qualified Disabled and Working Individuals Program
The final program is the Qualified Disabled and Working Individuals (QDWI), which pays for your Part A premiums. In order to enroll in the QDWI program, you have to fit one of the following qualifications:
- You’re disabled, working, and younger than 65
- You lost premium-free Part A when you returned to work
- You aren’t receiving medical assistance from your state
- You meet any of the income and resource limits for the year
The 2019 income and resource standard limits for QDWI are:
- Monthly individual income limit: $4,249
- Annual individual resource limit: $4,000
- Monthly married couple income limit: $5,722
- Annual married couple resource limit: $6,000
How to Apply
If you fulfill the basic requirements for a Medicare Savings Program and fall under the income and resource limits, you may be eligible for a program. To find out the specifics or to get the ball rolling, contact your state Medicaid Program or your State Health Insurance Assistance Program. Even if you’re above some of the limits listed above, you may still be eligible, so it’s worth checking.
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If you’re ineligible for an MSP, fret not, you can still save money on Medicare insurance. Using the Shop & Enroll Plan Finder, you can explore which plans are available in your area and connect with a licensed sales agent who can help you find savings and see what plans fit your needs.