This article outlines the four Medicare savings programs and provides helpful information for determining eligibility.
What programs exist to help cover my Medicare costs?
Medicare offers 4 general programs to help patients cover their out-of-pocket costs, which include premiums and cost-sharing for provider services and medications. Program eligibility is based on income and resources (checking and savings accounts, stocks, and bonds).
Qualified Individual Program (QI): Beneficiaries earning less than $1549/mo. and resources under $8400 may be eligible for the Qualifying Individual program (QI). This helps pay for Part B premiums only. States approve this on a first come, first serve basis. Ineligible if you qualify for Medicaid. Can pay for up to 3 months retroactively.
Qualified Medicare Beneficiary Program (QMB): Beneficiaries are eligible for QMB with incomes less than $1153/mo. and resources under $8400. This program covers premiums for Part A and Part B, deductibles, coinsurance, and copayments for services Medicare covers. It does not offer retroactive payment.
Specified Low-Income Medicare Beneficiary (SLMB): Beneficiaries are eligible for SLMB with incomes less than $1379/mo. and resources under $12,600. This covers Part B premiums. Can pay for up to 3 months retroactively.
Qualified Disabled Working Individual Program (QDWI): Disabled beneficiaries are eligible for QDWI with individual incomes less than $4615/mo. and resources under $4000. This pays for Part A premiums only.
What other resources exists to help cover my Medicare costs?
Several non-profits offer resources.
Accessia Health (800-366-7741) helps cover Medicare premiums.
The PAN Foundation (866-316-7263) helps cover premiums and out-of-pocket costs
The Assistance Fund (855-845-3663) helps with copayments, coinsurance, and deductibles.
How can I cover my out-of-pocket costs if I am ineligible for any of the Medicare Savings programs?
The primary step would be to see if you are eligible for a Medigap/Supplemental Insurance policy. This covers Part A and B costs not supported by Medicare.
What can BioMatrix do to help with Medicare coverage resources?
BioMatrix can check your Medicare benefits and let you know what your anticipated costs will be based on your plan choices. By looking at your income and resources, we can identify support plans you may be eligible for. We can also investigate your state rules regarding Medigap coverage plans and determine your eligibility.
Where can I learn more about the Medicare savings programs?
You can learn more about Medicare savings programs here at this link.
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