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Law Office of Brian S. Karpe Canton Estate Planning & Probate Lawyer
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What Are Medicare Savings Programs?

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You may be able to get help from Connecticut paying your Medicare premiums. In some cases, Medicare Savings Programs may also pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles, coinsurance, and copayments if you meet certain conditions.  There is a federal government program that provides funding that low-income seniors can access to pay for Part B premiums and co-payments. You may know someone who is receiving this benefit and you want to know how you can too.

Low-income seniors and disabled people who are eligible for Medicare Part A, which pays for hospital care and other inpatient services, may also be eligible for one of several Medicare buy-in programs that pay all or part of their Medicare Part B insurance premiums (which mainly cover doctor’s bills) and in some cases certain other expenses. Connecticut’s federally-required program is implemented through Connecticut’s Medicaid program.

General Program Information

There are several levels of lower-income Medicare beneficiaries that can receive some sort of help in paying their Medicare Part B premiums and, in some cases other expenses. In all cases, there are specific asset limits for individuals and for couples.  But these countable asset limits do not necessarily include the applicants’ homes or certain other items.

One such program is the Qualified Medicare Beneficiary (QMB) program.  This program limits eligibility to the guideline income of 100% of the federal poverty level (FPL), which is adjusted annually. For QMBs, the state Medicaid program pays Medicare Part B premiums, annual deductibles, and copayments up to the Medicaid rate. Essentially, the program provides the same benefits as many private Medicare supplement insurance policies without the extra cost of buying a private policy. A big difference is that the QMB program does not cover prescriptions but some privately purchased Medicare supplement policies provide a limited prescription coverage. However, some QMBs may also be eligible for full Medicaid coverage which would include prescriptions and certain other kinds of services that Medicare does not normally cover.

The second program is for Specified Low-Income Medicare Beneficiary (SLMB).  This program covers people whose incomes are between 100% and 120% of the FPL. This program pays for the Part B monthly premium only.

The third program is the Qualifying Individual Program (QI).  This is a state program that helps pay Part B premiums for people who have Medicare Part A and limited income and resources.  This program also only helps pay Part B premiums. You must apply every year for QI benefits.  QI applications are granted on a first-come, first-served basis, with priority given to people who got QI benefits the previous year.  However, if you qualify for Medicaid, you are not entitled to QI benefits. 

Call Canton Social Security Attorney Brian S. Karpe

If you or a loved one is concerned about rising medical costs, the burden of paying for assisted living or what help you may qualify for, contact Canton elder law attorney Brian S. Karpe. Mr. Karpe practices throughout Connecticut. He also has additional educational training and a Master of Laws degree in estate planning and elder law. He is a recognized leader in the field and relishes the opportunity to assist clients of all ages with estate planning and advanced health planning considerations. Contact him today to schedule a consultation and learn more about your options.

Resource:

ssa.gov/OP_Home/ssact/title19/1900.htm

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