Save on Medicare Costs: Extra Help, Medicare Savings Programs, and Dual Eligibility
While Medicare is intended to help cover health costs, there are still some things you could be required to pay for including premiums, deductibles and copays. To help limit these out-of-pocket costs, there are a number of savings programs available to Medicare beneficiaries with limited incomes.
Navigating all your options can be time-consuming and confusing, but the good news is that we can help you sort through all your options, making sure you’re receiving the benefits you deserve at a price that works for you.
Four Medicare Savings Programs
In short, Medicare Savings Programs (MSPs) are intended to help qualifying individuals afford Medicare. They are run at the state level, with each program having a different income and resource eligibility limits. There are four types of Medicare Savings Programs, three of which are available only if you have Medicare and are at least 65.
1. Qualified Medicare Beneficiary (QMB) Program
The Qualified Medicare Beneficiary (QMB) Program can help qualified individuals meet the costs of Medicare premiums and deductibles. Through the program, the government makes monthly premium payments toward a recipients’ Medicare Part A (when applicable) and Medicare Part B plans, and covers deductibles, co-insurance payments, and some prescription drug costs.
2. Specified Low Income Medicare Beneficiary (SLMB) Program
The Specified Low Income Medicare Beneficiary (SLMB) Program helps cover the cost of Medicare Part B premiums.
3. Qualifying Individual (QI) Program
The Qualifying Individual (QI) Program also helps pay for Medicare Part B premiums. You must reapply every year for QI as benefits are granted on a first-come, first-serve basis. Priority is given to people who received benefits through the program the previous year.
4. Qualifying Disabled and Working Individuals (QDWI) Program
The Qualifying Disabled and Working Individuals (QDWI) Program is administered by each state’s Medicaid program and helps pay for Medicare Part A premiums. Disabled individuals under 65 who are currently working could potentially qualify for this program.
Low-Income Subsidy (Medicare Extra Help)
The Medicare Part D Extra Help Program (also referred to as Low-Income Subsidy) is meant to help people with limited income pay for prescription drugs. Individuals enrolled in both Medicaid and Medicare—often called dual eligible—automatically qualify for Extra Help. Additionally, those receiving Supplemental Security Income (SSI) or qualify for a Medicare Savings Program qualify for Extra Help.
Dual Eligibility Program (Medicare Medicaid Eligibility)
‘Dual eligibility’ is when an individual is eligible for both Medicare and Medicaid. It’s easy to confuse the two, so it’s important to know the differences. Medicare is a federal health insurance program for seniors and disabled persons, while Medicaid is a state and federal medical assistance program for people with limited incomes and resources.
Individuals enrolled in both Medicaid and Medicare could receive greater healthcare coverage and have lower out-of-pocket costs.
Want to save on Medicare costs?
We specialize in helping consumers understand the ins and outs of Medicare. We can ensure you’re getting all of the available Medicare benefits you deserve at a price that’s right for your budget. In just minutes, we can compare all the Medicare options from the companies we represent available in your area. Some plans have premiums as low as $0/month* and might also include dental, vision and prescription drug coverage.
Don’t wait to ensure you’re getting all the benefits you deserve. Get started today—there’s no obligation to enroll.