Medicare Savings Programs help you pay for your Original Medicare if you have limited resources and a low income.
Medicare Part A and Part B make up Original Medicare, which comes with a variety of costs. For Part A and Part B, you have to pay monthly premiums. The majority of people receive Part A with $0 premiums because they have worked long enough while paying taxes to Social Security. Everyone pays Part B premiums. Part B has a yearly deductible and Part A has a deductible for each benefit period within the year, which is the time between being admitted as an inpatient and not having received inpatient care for 60 days. You also pay daily coinsurance after 60 days in the hospital and 20 days in a skilled nursing facility. You pay 20% of the Medicare-approved amount for covered services as copayments for Part B.
Medicare Savings Programs
Medicare Savings Programs help people with low income and limited resources to afford their Medicare health insurance. They are a form of Medicaid designed for people aged 65 or older, people receiving Social Security Disability benefits, or people with certain disabilities or permanent kidney failure. All recipients must meet specific income and resource requirements.
In Idaho, you can apply for three available programs, provided you meet the eligibility requirements. These programs include the Qualified Medicare Benefit (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI). Each program has different requirements and coverage levels, helping to pay for the costs of Medicare Part A and Part B.
Qualified Medicare Benefit (QMB)
The QMB program helps people with low income and limited resources by helping to pay for Medicare Part B premiums, coinsurance, deductibles, and allowables on Medicare crossover claims. Under certain circumstances, the QMB can help cover Part A premiums as well.
Recipients of the QMB also qualify for Extra Help, Medicare’s subsidized prescription drug program for people with low incomes. Extra Help helps pay for the Part D monthly premiums, deductibles, and copays. This program limits the amount your copayments are allowed to be for generic and brand-name drugs. In 2021, generic prescription drugs with Extra Help can cost no more than $3.70 and brand-name prescription drugs can cost no more than $9.20 each.
Specified Low-Income Medicare Beneficiary (SLMB)
The SLMB program covers the Medicare Part B premiums for Medicare beneficiaries who are already receiving Medicare Part A, have limited resources, and have an income below the federal poverty line.
SLMB recipients are also eligible for help paying for a Medicare Part B prescription drug program through Extra Help. This grants a cap on the amount that generic and brand-name prescriptions can cost. It also helps to pay for deductibles, copayments, and monthly premiums.
Qualifying Individual (QI)
The QI program only helps to pay for Medicare Part B premiums. It has specific requirements of a low income and limited resources.
Finding Medicare Savings Plans in Idaho
To find out if you qualify for a Medicare Savings Program in Elmore, Boise, Owyhee, Canyon, Ada, Gem, or Payette counties, enlist the help of Generations Insurance. Our Medicare experts are trained to support you with all things health insurance and can help you navigate the enrollment so that you can start saving on your health care costs.
Start Your free Quote Today