Resources to help cover Medicare costs
Dear Savvy Senior,
Are there any sources you know of that can help me save on my Medicare coverage? I’m 65 and live primarily on my Social Security, and I’m having a hard time paying my Medicare out-of-pocket costs.
—Need Some Help
Dear Need,
There are several financial assistance programs that can help lower-income Medicare beneficiaries who are having a difficult time paying their out-of-pocket health care costs.
Here’s what’s available, along with the eligibility requirements and how to apply.
Medicare Savings Program
Let’s start with a program that helps pay premiums and out-of-pocket costs for Medicare Parts A and B. It’s called the Medicare Savings Program (MSP), and it has several different benefit levels for people based on their income and asset level.
At its most generous, the program will pay your Part A and B premiums and pretty much all your Medicare deductibles, coinsurance and copayments. At its least generous, the program will pay just your Part B premium.
To qualify for an MSP, the minimum standard set by Medicare is that your income be under 135 percent of the federal poverty level, which at the moment works out to around $1,426 a month for individuals ($1,923 for married couples). Everything counts towards income, including payouts from 401(k) plans, pensions, Social Security and help from family members.
Medicare also allows states to impose an asset test, which can be as little as $7,730 per individual ($11,600 for married couples), not counting your house or car, but counting retirement savings and bank accounts.
But some states have made their MSP programs a lot more generous, with much higher income limits and in some cases no asset tests at all. The program may also be called something else in your state.
To find out if you qualify or to apply, contact your state Medicaid program.
Maryland residents should visit https://health.maryland.gov/mmcp/eligibility/Pages/medicare-savings-programs.aspx or call (800) 638-3403.
In Virginia, visit https://dss.virginia.gov/benefit/medical_assistance/index.cgi or call your local Social Services department. The phone numbers for each department are listed at https://dss.virginia.gov/localagency/index.cgi.
For Washington, D.C. residents, visit https://dhcf.dc.gov/service/qualified-Medicare-beneficiary-qmb or call (202) 442-5988.
Extra Help with meds
For help with Medicare Part D prescription drug plan costs, there is a completely separate program called Extra Help. To get it, you’ll need to apply through your local Social Security office.
Depending on how low your income is, this program will pay part or all of your Part D prescription drug plan’s monthly premiums, annual deductibles and prescription co-payments.
In 2019, individuals with a yearly income below $18,735 ($25,365 for a married couple), and assets under $14,390 ($28,720 for a married couple) can qualify for Extra Help.
And if you’re eligible to be in the Medicare Savings Program described above, you will automatically qualify for Extra Help. But because the requirements are slightly different, even if you don’t qualify for a Medicare Savings Program for Part B you might be able to get Extra Help for Part D.
For more information or to apply, Marylanders should visit https://aging.maryland.gov/Pages/MedicarePartD.aspx or call (800) 243-3425.
Virginians should go to https://vda.virginia.gov/vicap.htm or call your local aging department with phone numbers listed at https://www.dss.virginia.gov/benefit/medical_assistance/.
D.C. residents may visit https://dhcf.dc.gov/service/qualified-Medicare-beneficiary-qmb or call (202) 442-5988.
Other assistance programs
Depending on your income level, needs and location, there are many other financial assistance programs that can help, such as Medicaid, SSI (Supplemental Security Income), PACE (Program of All-inclusive Care for the Elderly), SNAP (Supplemental Nutrition Assistance Program), (LIHEAP) Low Income Home Energy Assistance Program and many others.
To help you find out what types of assistance programs you may be eligible for, and learn how to apply for them, go to BenefitsCheckUp.org. This is a free, confidential Internet tool designed for people 55 and older that contains information about more than 2,500 programs.
It’s also possible to get help in person at one of the 87 Benefits Enrollment Centers scattered across the U.S. Call 1-888-268-6706 or visit NCOA.org/centerforbenefits/becs to locate a center near you. There are multiple sites in the Greater Washington area. Some centers also offer assistance over the phone.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of The Savvy Senior book.