Saving money is always helpful, especially when it comes to senior health care. HealthMarkets shares information about 4 types of Medicare Savings Programs and how to qualify.
Like health needs, insurance plans change frequently.
And just like an annual doctor’s check-up evaluates overall health, a regular check-in with your older adult’s health insurance plans could save them money.
With Medicare program requirements changing annually, it’s possible that they could qualify to get more savings.
Find out about 4 Medicare Savings Programs and how to know if your older adult qualifies.
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There are 4 Medicare Savings Programs
There are four types of Medicare Savings Programs:
- Qualified Medicare Beneficiary (QMB)
- Specified Low-Income Medicare Beneficiary (SLMB)
- Qualifying Individual (QI)
- Qualified Disabled and Working Individuals (QDWI)
Each of these savings programs is based on monthly income limits on money in the beneficiary’s bank, stock, and bonds accounts.
If your older adult is eligible for Medicare Part A and meets the income limits or has limited resources, they may qualify for these additional Medicare savings.
However, even if someone’s income is slightly higher than the published requirements, they may still qualify. So it could be worth the effort to apply to find out if they could get the extra savings.
Under each program, your older adult’s state would provide help in paying their Medicare premiums.
Additional help with Part A and Part B deductibles, coinsurance, and copayments may also be available if they meet certain conditions.
An additional prescription drug savings program
In addition to those four Medicare Savings Programs, the Medicare Low-Income Subsidy (LIS), also known as Extra Help, provides help with Medicare Part D prescription drug costs for those with low incomes.
People who qualify for the QMB program, SLMB, or QI program automatically qualify for the Extra Help program.
Saving money on prescription drugs can help people save thousands of dollars each year. In fact, in 2019, more than 350,000 individuals who applied for this assistance through the government were eligible for savings.
And even though the 2020 enrollment period for Medicare has passed, there still may be an opportunity to save money and make changes to an existing plan.
For example, if they qualify for Extra Help, changes to existing plans can be made through a Special Enrollment Period (SEP).
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Find out if your older adult qualifies
Because annual income limits change for each program, it is important to re-evaluate insurance plans each year.
If your older adult meets the published income requirements, call their state’s Medicaid program or apply to find out if they qualify for a Medicare Savings Program.
There are various nuances with different Medicare plans and it can be confusing so you may want to work with a free Medicare counselor from a state program or a licensed health insurance agent who can help guide you through the process.
HealthMarkets also has an online quiz called FitScore that helps Medicare beneficiaries find health insurance coverage and uncover possible savings with your current Medicare plan.
FitScore includes a low-income subsidy (LIS) calculator that helps you determine if your older adult qualifies for Medicare’s Extra Help program.
In addition, you could answer a few quick questions about income and resources to uncover additional savings on prescription drug program premiums, deductibles, and coinsurance.
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Guest contributor: Michael Z. Stahl is the executive vice president and chief marketing officer of HealthMarkets, one of the largest independent health insurance agencies in the U.S. that distributes health, Medicare, life and supplemental insurance products from more than 200 insurance companies. Stahl holds the chartered property casualty underwriter (CPCU), associate in insurance accounting and finance (AIAF) and associate in reinsurance (ARe) designations, and earned a bachelor of science in economics from The Wharton School at the University of Pennsylvania. He lives in Dallas with his wife and four children.
Image: All Heart Care
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