While Medicare is intended to help cover healthcare costs, there are still some things you could be required to pay for including premiums, deductibles and copays. To help limit out-of-pocket costs, there are a few Medicare Savings Programs available to Medicare beneficiaries with limited incomes.
Three Ways to Save on Out-of-Pocket Expenses
Medicare Savings Program
Medicare Savings Programs (MSPs) are intended to help qualifying individuals better afford Medicare. Each program has different income and resource eligibility limits.
Qualified Medicare Beneficiary (QMB) Program
The Qualified Medicare Beneficiary (QMB) Program is a government program that makes monthly premium payments toward a qualifying recipients’ Medicare Part A (when applicable) and Medicare Part B plans, and covers deductibles, co-insurance payments, and some prescription drug costs.
Medicare beneficiaries who qualify for the QMB Program will also automatically qualify for the Medicare Part D Extra Help program that provides financial support with prescription drug costs.
Specified Low Income Medicare Beneficiary (SLMB) Program
The Specified Low Income Medicare Beneficiary (SLMB) Program helps cover the cost of Medicare Part B premiums for individuals who have Medicare Part A, a low monthly income and limited resources. Those who qualify for the SLMB Program also qualify for the Medicare Part D Extra Help program.
Qualifying Individual (QI) Program
The Qualifying Individual (QI) Program helps pay for Medicare Part B premiums. This program requires re-application each year and benefits are granted on a first-come, first-serve basis, with priority given to those who received benefits through the program the year before.
Qualifying Disabled and Working Individual (QDWI) Program
The Qualifying Disabled and Working Individual (QDWI) Program is a state administered Medicaid program that 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)
Medicare Low-Income Subsidy—also known as the Medicare Extra Help Program—helps individuals with fixed incomes pay for some if not most of the out-of-pocket costs of Medicare prescription drug coverage. It’s also known as Part D Low-Income Subsidy.
Dual Eligibility Program (Medicare and Medicaid Eligibility)
Dual eligibility is when an individual is eligible for both Medicare and Medicaid. Individuals enrolled in both Medicaid and Medicare could receive greater healthcare coverage and have lower out-of-pocket costs. Medicare is typically the primary payer for medical expenses and hospitalization. Medicaid will often cover the remainder if Medicare doesn’t cover the full cost.
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Navigating all your options can be time-consuming and confusing, but we can help make sure you’re receiving the benefits you deserve at a price that works for you. There’s no obligation to enroll.