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Save on Medicare Costs: Extra Help, Medicare Savings Programs, and Dual Eligibility
While Original Medicare is intended to help cover health costs, you may still be required to pay for some expenses, including premiums, deductibles, and copays. To help limit these out-of-pocket costs, there are a number of savings programs available to Original 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 the options that may be available to you.
Four Medicare Savings Programs
In short, Medicare Savings Programs (MSPs) are intended to help qualifying individuals afford Original Medicare. They are run at the state level, with each program having different income and resource eligibility limits. There are four types of MSPs, three of which are available only to those with Original Medicare and who are at least 65.
1. Qualified Medicare Beneficiary (QMB) Program
The Qualified Medicare Beneficiary (QMB) Program can help qualified individuals meet the costs of Original Medicare premiums and deductibles. Through the program, the government makes monthly premium payments toward a recipient’s 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-served 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) helps people who have limited income pay for prescription drugs. Individuals enrolled in both Medicaid and Original Medicare—often called dual eligible—automatically qualify for Extra Help. Additionally, those receiving Supplemental Security Income (SSI) or who qualify for a Medicare Savings Program qualify for Extra Help.
Dual Eligibility Program (Original Medicare and Medicaid Eligibility)
"Dual eligibility" is when an individual is eligible for both Original Medicare and Medicaid. It’s easy to confuse the two, so it’s important to know the differences. Original 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 Original Medicare could receive greater healthcare coverage and have lower out-of-pocket costs.
Explore Medicare Advantage Plans with SelectQuote
We specialize in helping consumers understand the ins and outs of Medicare Advantage plans. We can help you understand Medicare Advantage plans and possible additional routine benefits that may be available in your area. It’s free and there’s no obligation to enroll.
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We do the shopping. You do the saving.
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