Programs can reduce your Medicare costs
June 1, 2017
Are you aware that Medicare works with the State of Alaska to provide assistance programs that can help with your Medicare costs?
These costs can include your Medicare Part A & Part B premiums deductibles, coinsurance charges and copayments. These programs are available to all Medicare beneficiaries.
There are three programs known as the Medicare Savings programs (MSPs), each having different income limits and resource parameters. The income and asset qualifications are different if you are single or married. MSPs are also referred to as the Medicare Buy-In programs because the state is “buying” some of your Medicare costs.
While these programs are available in all states (not in Puerto Rico or the U.S. Virgin Islands), the income limits for these programs is higher in Alaska.
The Qualifying Individual (QI) program has the highest income and asset limits of the MSPs. It will pay for your Part B premium and provides three months Part B reimbursement from the month of the application. You cannot have both QI & Medicaid. The income limit for an individual is $1,715 per month and asset limit is $7,390. For a couple, the income limit is $2,303 per month and the asset limit is $11,090.
The Specified Low-income Medicare Beneficiary (SLMB) program will pay for your Part B premium and provides three months retroactive Part B premium reimbursement from the month of application. You can have SLMB and Medicaid. The income limit for an individual is $1,526 and the asset limit is $7,390. For a couple, the income limit is $2,049 and the asset limit is $11,090.
The Qualified Medicare Beneficiary (QMB) program will pay for your Part B premium and Medicare deductibles, coinsurance charges and copayments. QMB will also pay for your Part A premium if you have to pay for Part A. This program does not provide three months retroactive Part B premium reimbursement, but the benefits start the first of the month after the month you are approved for the program. You can have Medicaid and QMB. It is not beneficial to have supplemental Medicare (Medigap) if you are enrolled in the QMB program. The income limit for individuals is $1,275 and the asset limit; $7,390. For couples, the income limit is $1,711 and the asset limit is $11,090.
If you are slightly over the income limits, don’t hesitate to apply anyway as there are certain situations that allow a higher income. Assets that the programs do not count against you are: The home that you live in, the car you drive, your household items, burial space or burial funds valued up to $1,500. They also do not count life insurance with a cash value of less than $1,500.
Other MSP advantages
There are some extra benefits for being enrolled in a Medicare Savings Program. If you have not yet enrolled in Medicare, you will be allowed to enroll outside of the regular enrollment periods, which may enable you to get your Medicare benefit more quickly.
Qualifying for an MSP eliminates having to pay a Part B late enrollment penalty (LEP) if one has been charged to you for not enrolling in Medicare when you were first eligible.
You will automatically be enrolled in the Extra Help Program, also known as the Limited Income Subsidy (LIS). This program is a federal program that assists in paying Part D prescription drug costs.
Another benefit for those who qualify for QMB and Original Medicare is that providers cannot bill you for Medicare deductibles, coinsurance charges or copayments. If a provider agrees to treat you, they cannot bill you for the services that you receive after Medicare has paid their portion. This is known as improper billing.
How to apply
You can call the Medicare Information Office to be screened for MSPs and the Extra Help program. The Extra Help program has higher income and asset amounts so you may qualify for this program even if you don’t qualify for the MSPs and there is an online application tool that can be used as well as a paper application.
The application for the MSPs is called the GEN 50-C and can be accessed online as a pdf at http://dpaweb.hss.state.ak.us/e-forms/pdf/Gen50c.pdf. They must be printed out then completed. GEN 50-C applications can also be obtained at the Adult Public Assistance/Medicaid Office and at the Medicare Information Office.
Once completed, the application is processed by Adult Public Assistance. This application can be used to apply for a number of assistance programs.
If you find that you don’t qualify at this time, don’t hesitate to re-apply in the future, as the income levels are adjusted annually.
All three of the MSPs cover the Part B premiums so if you qualify, you could have a larger Social Security benefit.
Nila Morgan is a certified Medicare Counselor and Medicare Fraud Education Coordinator who works at the Anchorage Senior Activity Center.