Medicare Mistake #10:

Not Taking Advantage of Discounts

If your income is limited, you may qualify for discounts that lower Medicare expenses

Medicare Savings Program

Your state may help pay the Part A (Hospital Insurance) and the Part B premiums (medical insurance) and additional expenses

According to Medicare.gov, there 4 kinds of Medicare Savings Programs are:

Qualified Medicare Beneficiary Program

• Helps pay for Part A and B premiums, deductibles, coinsurance, and co-payments
• Individual monthly income limit: $1,010
• Married couple monthly income limit: $1,355
• Individual resource limit: 47,280
• Married couple resource limit: $10,930

Specified Low-Income Medicare Beneficiary Program- helps pay for Part B premiums only

• Helps pay for Part B premiums only
• Individual monthly income limit: $1,208
• Married couple monthly income limit: $1,622
• Individual resource limit: $7,280
• Married couple resource limit: $10,930

Qualifying Individual Program

• You have to apply for Qualifying Individual benefits every year. These are granted based on a first come first serve basis, with priority given to those who received QI benefits last year.
• QI helps pay for Part B premiums only
• Individual monthly income: $1,357
• Married couple monthly income limit: $1,823
• Individual resource limit: $7,280
• Married couple resource limit: $10,930

Qualifying Disabled and Working Individuals Program

• If you qualify for a QMB, SLMB, or QI program, you automatically qualify to get extra help paying for Medicare prescription drug coverage.
• Helps pay for Part A premiums only

The QDWI program helps pay the Part A premium. You may qualify if you:

• Are a working disabled person under 65
• Lost your premium-free Part A when you went back to work
• Are not getting medical assistance from your state
• Meet the income and resource limits required by your state

QDWI income & resource limits in 2016:

• Individual monthly income limit: $4,045
• Married couple monthly income limit: $5,425
• Individual resource limit: $4,000
• Married couple resource limit: $6,000

Countable resources include:

• Money in a checking or savings account
• Stocks
• Bonds

Countable resources don’t include:

• Your home
• One car
• Burial plot
• Up to $1,500 for burial expenses if you have put that money aside
• Furniture
• Other household and personal items

Federal Extra Help Program

Send in any of the following documents to check for which level of extra help you are entitled to with your plan:

• A purple notice from Medicare that says you automatically qualify for Extra help
• A yellow or green automatic enrollment notice from Medicare
• An Extra Help “Notice of Award” from Social Security
• An orange notice from Medicare that says your co-payment amount will change next year
• If you have Supplemental Security Income, you can use your award letter from Social Security as proof that you have SSI
• Best Available Evidence document

Proof you have Medicaid and live in an institution or get home- and community-based services

• A bill from the institution, like a nursing home, or a copy of a state document showing Medicaid paid for your stay for at least a month.
• A print-out from your state’s Medicaid system showing you lived in an institution for at least a month and that Medicaid paid for your stay.
• A document from your state that shows you have Medicaid and are getting home- and community-based services.

Other proof you have Medicaid

• A copy of your Medicaid card (if you have one).
• A copy of a state document that shows you have Medicaid.
• A print-out from a state electronic enrollment file or from your state’s Medicaid systems that shows you have Medicaid.
• Any other document from your state that shows you have Medicaid.

Your plan must:

• Pay less than the LIS drug coverage cost limit. In 2016, costs are no more than $2.95 for each generic and $7.40 for each brand-name covered drug.
• Prove you qualify by contacting Medicare. You can expect your request to take anywhere from several days to up to 2 weeks to process, and depending on the circumstances. Call 1-800-MEDICARE (1-800-633-4227).