Education for Justice FACT SHEET S-10 Fall 2009

MEDICARE SAVINGS PROGRAMS

You may be paying too much for your Medicare coverage. A Medicare Savings Program might be a good thing to think about.

WHAT IS A MEDICARE SAVINGS PROGRAM?

It is a State Medicaid program that can help pay for Medicare premiums and co-payments. If you are eligible for Medicare, you may also be eligible for one of the 4 Medicare Savings Programs (MSP.) In some situations you may be able to use them in addition to any Medical Assistance received. Your income will determine which, if any, program you qualify for.

WHAT ARE THE 4 PROGRAMS AND THE REQUIREMENTS?

1. Qualified Medicare Beneficiary (QMB)

• Covers payment of Medicare Part A premiums (up to $443/month in 2009)

• Covers payment of Medicare Part B premiums ($96.40/month in 2009)

• Covers payment of Medicare cost-sharing (co-payments and deductibles) for Medicare services provided by Medicare-eligible providers

You are eligible for QMB if:

• you are enrolled in or eligible to enroll in Medicare Part A

• your income is at or below $923 per month ($1,235 per month if you are married)

• your assets are less than $10,000 ($18,000 for a married couple)

2. Service Limited Medicare Beneficiary (SLMB)

• Covers payment of Medicare Part B premiums ($96.40/month in 2009)

You are eligible for SMLB if:

• you are enrolled in or eligible to enroll in Medicare Part A or eligible to enroll in Medicare Part B

• your income is at or below $1103 per month ($1,477 per month if you are married)

• your assets are less than $10,000 ($18,000 for a married couple)

3. Qualified Individuals (QI-1)

• Covers payment of Medicare Part B premium

• This program has limited funding, and gives benefits on a first come first served basis.

You are eligible for QI-1 if:

• you are enrolled in or eligible to enroll in Medicare Part A or eligible to enroll in Medicare Part B

• your income is at or below $1,239 per month ($1,660 per month if you are married)

• your assets are less than $10,000 ($18,000 for a married couple)

NOTE: Be clear that you want a Medicare Savings Program. Sometimes a county will enroll you in Medical Assistance with a high spenddown instead of the QI program. If you do not have monthly out-of-pocket medical bills that are higher than your spenddown, the Medical Assistance Program will not help you.

4. Qualified Working Disabled (QWD)

• Covers payment of Medicare Part A premiums (up to $443/month)

• If you qualify for MA or MA for Employed Persons with Disabilities (MA-EPD,) you are not eligible for QWD

You are eligible for QWD if:

• you are employed

• under age 65 with disabilities, but lost RSDI and (or) premium-free Medicare benefits because income exceeds Substantial Gainful Activity (SGA) limits

• your income is at or below $1,825 per month ($2,449 per month if you are married)

• your assets are less than $4,000 ($6,000 for a married couple)

HOW DO I APPLY?

· Call or visit your county’s welfare agency and ask for a combined application or a Health Care application.

· Fill out the application and return it with the required documentation to the county welfare agency. There is a list of what documents you need on the application.

· The agency will figure out if you are eligible.

Minneapolis Legal Aid – CLE MN Legal Services Coalition 2324 University Avenue W- Suite 101B St. Paul, MN 55114

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