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Medicare Savings Programs (online only)

April 2010

By Medicare Rights Center

Dear Marci,

I’m having trouble paying for my Medicare, and I’ve heard that a Medicare Savings Program could help me out. What do these programs cover, and what are the eligibility requirements?

—Jan

Dear Jan,

Medicare Savings Programs (MSPs), also known as Medicare Buy-In programs or Medicare Premium Payment Programs, help pay your Medicare costs if you have limited finances. There are three main programs, and each has different income eligibility limits. Not all states have all programs.

1.      Qualified Medicare Beneficiary (QMB): Pays for Medicare Part A and B premiums, deductibles and coinsurances or co-pays. If you have QMB, you will have no coinsurance or copayment for Medicare-covered services you get from doctors who participate in Medicare or Medicaid or are in your Medicare private health plan’s network.

2.      Specified Low-income Medicare Beneficiary (SLMB): Pays for Medicare’s Part B premium.

3.      Qualifying Individual (QI) Program: Pays for Medicare’s Part B premium.

To qualify for an MSP, you must have Medicare Part A and meet income and assets guidelines. If you do not have Part A but meet QMB eligibility guidelines, your state will have a process to allow you to enroll in Part A and QMB. Many states allow this throughout the year, but others limit when you can enroll in Part A.

States use different rules to count your income (money you take in, for example, Social Security payments that you get or wages that your earn) and assets (resources such as checking accounts, stocks and some property) to determine if you are eligible for an MSP. Certain income or assets may not count. Some states do not have an asset limit. Because rules vary by state, if your income or assets seem to be above the MSP guidelines, you should still apply if you need the help.

If you enroll in a Medicare Savings Program, you will also automatically get Extra Help, the federal program that helps pay most of your Medicare prescription drug costs (Part D).

—Marci

Marci’s Medicare Answers is a service of the Medicare Rights Center (www.medicarerights.org), the nation’s largest independent source of information and assistance for people with Medicare. To speak with a counselor, call (800) 333-4114. To subscribe to “Dear Marci,” the Medicare Rights Center’s free educational e-newsletter, simply e-mail dearmarci@medicarerights.org.