MEDICARE SAVINGS PROGRAMS Flashcards
What are Medicare Savings Progams?
Medicare Saving Programs are:
* Typically Federally funded programs
* The Help pay for Medicare costs
The individual state Medicaid offices administer the Medicare Savings Programs. The programs can help pay for deductibles, coinsurance, and co-payments associated with the out-of-pocket costs for Medicare services.
When you retire and/or are on a low-fixed income every penny counts. Even if yo 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, but for Part B there’s a monthly premium. Many people get assistance paying for their Part B from a Medicare Savings Program.
When you’re approved for a Medicar Savins Program you also automatically qualify for Extra Help with Medicare Part D.
Explain Extra Help for Part D Low Income Subsidy
Medicare Savings Programs (MSP) = Automatic Extra Help for Part D Low Income Subsidy (LIS)
Provides reduced costs for prescription medications to Medicare beneficiaries with income and resources below certain qualifying levels.
When you get Extra Help there’s no Part D lat enrollment penalty to worry about if you didn’t apply for a drug plan when you were first eligible.
What is the criteria to apply for Medicare Savings Plans (MSP’s)?
- You must already have or be eligible for Medicar Part A.
- Your income must be at or below the Federal or state limits for the specific program.
- Your resources must be below the Federal or state limits where you reside.
There are 4 Types of Medicare Savings Programs
What are the concerns of the Medicare Savings Programs?
- Income & Asset guidelines
- Guidelines are state specific
- Limits vary from state to state: Some states don’t have limits on the amount of your resources or assets you can have.
Note: These limits can go up every year. So you’re encouraged to apply even if your income and resources are slightly higher than the amounts listed.
The Resources that are counted in the Medicare Savings Program limits are:
- Money in checking or savings accounts
- Stocks and Bonds
The resources that are NOT COUNTED in the Medicare Savings Program limits are:
- Your primary residence,
- one car,
- burial plots
- Money for Burial expenses u to $1,500
- Furniture
- Household and personal items
Note: Income and Assets limites can vary amongst the different states.
Alaska and Hawaii have the highest limits of all the other states
What are the 4 Types of Medicare Savings Programs (MSP’s)?
- Qualified Medicare Beneficiary (QMB)
- Specified Low-Income Medare Beneficiary (SLMB)
- Qualifying Individual (QI)
- Qualified Disabled Working Individual (QDWI)
**Explain the Qualified Medicare Beneficiary (QMB) Medicare Savings Program (MSP) for 2024:
- Qualified Medicare Beneficiary (QMB):
- Monthly Income Limits:
Individual: $1,275
Married Couple: $1,724 - Resource Limits:
Individual: $9,430
Married Couple: $14,130
QMB Benefits:
- Coverage for Part A deductible, premium, and hospital co-pays
- Silled Nursing facility co-pays, the Part B monthly premium, Part B deductible, and Part B 20% coinsurance
Generally, you will not receive a bill for Medicare covered services except for a bill for Part D prescription drugs at a reduced costs.
The QMB program covers Part A premiums, Part B premiums, and other costs like deductibles, coinsurance, and copayments. Keep in mind that some states may have different income and resource limits, so it’s a good idea to check with your state’s program to confirm eligibility.
If you qualify for QMB, you’ll also automatically qualify for Extra Help, which helps pay for Medicare prescription drug coverage. Remember that income limits are slightly higher in Hawaii and Alaska.
Explain the Specified Low-Income Medicare Beneficiary (SLMB) Medicare Savings Program(MSP) for 2024:
The Specified Low-Income Medicare Beneficiary (SLMB) program assists with Part B premiums for individuals who meet the income and resource criteria. Here are the income and asset limits for 2024:
- Monthly Income Limits:
Individual: $1,526
Married Couple: $2,064
- Resource Limits:
Individual: $4,000
Married Couple: $6,000
- SLMB Benefits:
- Coverage for Part B monthly premium
Note: 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 then the Part B premium would be paid by the government.
Remember that these limits may vary slightly by state, so it’s essential to check with your state’s program to confirm eligibility. If you qualify for SLMB, you’ll also automatically qualify for Extra Help, which helps pay for Medicare prescription drug coverage
Explain the Qualifying Individual (QI) Medicare Savings Program(MSP) for 2024:
Qualifying Individual (QI):
The Qualifying Individual (QI) program assists with Part B premiums for individuals who meet the income and resource criteria. Here are the income and asset limits for 2024:
- Monthly Income Limits:
Individual: $1,715
Married Couple: $2,320 - Resource Limits:
Individual: $9,430
Married Couple: $14,130
QI Benefits:
Coverage for Part B monthly premium only (must re-apply every year)
Remember that these limits may vary slightly by state, so it’s essential to check with your state’s program to confirm eligibility. If you qualify for QI, you’ll also automatically qualify for Extra Help, which helps pay for Medicare prescription drug coverage
Explain the Qualified Disabled Working Individual (QDWI) Medicare Savings Program (MSP) for 2024:
The Qualified Disabled & Working Individuals (QDWI) program assists with Part A premiums for individuals who meet the income and resource criteria. Here are the income and asset limits for 2024:
- Monthly Income Limits:
Individual: $5,105 (including a $20 general income exclusion)
Married Couple: $6,899
- Resource Limits:
Individual: $4,000
Married Couple: $6,000 - QDWI Benefits: Coverage for the Medicare Part A premium
You may be eligible if you’re uder age 65, disabled, and working with limited income and resources
Remember that these limits may vary slightly by state, so it’s essential to check with your state’s program to confirm eligibility. If you qualify for QDWI, you’ll also automatically qualify for Extra Help, which helps pay for Medicare prescription drug coverage
