The spike in healthcare costs is impacting senior Americans, with many having to spend more than they can afford on premiums and out-of-pocket expenses. If you’re a low-income earner or need help with Medicare costs, there are some federal and state programs you can sign up for, such as:
Medicare Savings Programs
Medicare Savings Programs is state-run and can help pay your Part A and Part B premiums and out-of-pocket expenses, including deductibles, copays, and coinsurance. The Medicare Savings Programs consist of 4 different levels. To qualify for any of the levels, you have to meet specific income requirements.
Qualified Medicare Beneficiary (QMB) Program
It helps pay for premiums, copays, deductibles, and coinsurance and has a monthly limit of $1,153 and a resource limit of $8,400 in 2022. Married couples must have a monthly limit of $1,546 and a resource limit of $12,600.
Specified Low-Income Medicare Beneficiary (SLMB) Program
The monthly income and resource limits for individuals are $1,379 and $8,400, while married couples can qualify if their monthly income doesn’t exceed $1,851 and assets are not worth more than $12,600 in 2022. SLMB helps assist with only Part B premiums.
Qualifying Individual (QI) Program
The QI program also helps with Part B premiums. To qualify, your monthly income in 2022 shouldn’t exceed $1,549 and $2,080 as an individual or couple, respectively. Individuals shouldn’t have more than $8,400 in assets, while couples have a limit of 12,600.
Qualified Disabled Working Individual (QDWI) Program
The QDWI program is designed for individuals who have a disability and are working. They must also have lost their social security benefits and premium-free Part A due to returning to work. The income limit in 2022 is $4,615 for individuals and $6,189 for married couples. Individuals shouldn’t have more than $4,000 in assets, while the asset limit for a married couple is $6,000.
If you need help with drug costs, the Extra Help program is designed for you. It can assist with paying for premiums, copayments, deductibles, and coinsurance. Also, you won’t have to pay the Part D late enrollment penalty.
To be eligible for the Extra Help program, your income must not exceed $20,385 if you are an individual and $27,465 if you are married. All your assets must be worth $15,510 or less as an individual and $30,950 if you are married.
You can automatically get Extra Help if you have full Medicaid coverage, your state helps pay your Part B premiums, or you have Supplemental Security Income from Social Security.
Medicare-Medicaid Plans (MMPs)
If you’re enrolled in Medicare and receive full Medicaid benefits, you can sign up for a Medicare-Medicaid Plan. It is only available in certain states with eligibility requirements, costs, and services covered vary from state to state. If you qualify, an MMP will help coordinate your Medicare and Medicaid benefits, simplify the process, and make it easy for you to get the services you are entitled to.
PACE stands for the Programs of All-Inclusive Care for the Elderly and is available if you’re 55 or older. Other requirements include the following:
Needing nursing home-level care.
Living in a PACE organization’s service area.
Being able to live safely in your community.
PACE covers Medicare and Medicare benefits, including prescription drugs and additional healthcare services not covered by Medicare.
Learn more about how these programs and others can help lower your Medicare costs by speaking with our licensed Medicare agents.