Connect
To Top

Four Types of Medicare Savings Programs You Can Buy to Cover Out-Of-Pocket Expenses

Medicare Savings Program can play a crucial role in helping people from the low-income strata by covering several Medicare costs, which includes the premiums, copayments, deductibles, and coinsurance associated with Part A as well as Part B programs. If you qualify for specific Medicare Savings Programs, you will be eligible for an Extra Help Program, which will be highly beneficial as far as the prescribed drug cost is concerned. Qualified Medicare Beneficiary Program, Qualifying Individual Program, Qualified Disabled and Working Individuals Program and Specified Low-Income Medicare Beneficiary Program are the four types that Medicare Savings Program can be categorized into. Get to know about them in detail below.

Qualified Medicare Beneficiary Program

The Qualified Medicare Beneficiary Program happens to be a Medicare Savings Program. It can help you cover the hospital insurance premium under Medicare Part A. The medical insurance premium under Medicare Part B. Through this program, the cost-sharing additional expenses under Medicare, such as coinsurance, copayments, and deductibles, are covered. If you are eligible for this program, you will eventually earn eligibility for the Extra Help program for prescription drugs.

This will save you from bearing out-of-pocket medication costs. If you want to apply for this particular program, you must qualify for or be currently availing Medicare Part A. To determine if you are eligible for the program or not, a subsidy asset test is executed. Factors that are taken into consideration include liquid assets like bonds, stocks, savings account, and checking accounts.

Qualified Individual Program

The Qualifying Individual Program is considered to be a secondary program to the primary Medicare Savings Program. In case you don’t have the eligibility for Specified Low-income Medicare Beneficiary Program or Qualified Medicare Beneficiary Program, you can instead attempt applying for the QI Medicare Savings Program. This program covers your premiums under Medicare Part B.

You automatically become eligible for Extra Help prescription drug program. Know that you have to apply every year to avail of the benefits. Aside from that, these benefits are offered on a first-come-first-served basis owing to the limitations of program funding. More priority is given to those who received prior QI benefits. In case you are eligible for Medicaid, you won’t qualify for the QI benefits.

Specified Low-Income Medicare Beneficiary Program

Individuals who rake in a bit higher than the maximum income requirement under the Qualified Medicare Beneficiary Program might be considered eligible for this program. The SLMB program covers Medicare Part B premiums. Although it doesn’t pay your premiums under Medicare Part A and other expenses which require cost-sharing, it allows you to rake in a higher amount as your income. Just like what happens in the QMB program, if you are eligible for the SLMB program.

You become eligible for the Extra Help prescription drug program too. Like you do under the QMB program, you must meet income as well as asset requirements to get qualified. Eligibility criteria might get altered every year.

Qualified Disabled and Working Individuals Program

The QDWI or Qualified Disabled and Working Individuals Program doesn’t act the same way as the other three. QDWI pays for the premiums as per Medicare Part A. You become eligible for this if you are under 65 years, physically challenged, and currently employed somewhere. Also, you should not be receiving state medical assistance, suffice the resource and income requirements of the state you live in and have lost your coverage that Medicare Part A offers. Toeing the line of the other Medicare Savings Programs, the asset and income requirements for this program may get altered from time to time.

There are some documents and facts that will be taken into account while determining if you are eligible or not. The list includes checking accounts, savings accounts, bonds, stocks, mutual funds, and individual retirement accounts. The list of resources that will not be taken into consideration includes your residence, personal items, household items, furniture, burial plot, etc. Since Medicaid programs run the programs in your state, some states might calculate assets and income distinctly. This implies that you might have the eligibility even if the resources and income are higher than the listed limits. Contact the Medicaid office in your state for further queries.

More in Health Insurance

You must be logged in to post a comment Login