Turning 65 soon? Transitioning to dual Medicare and Medicaid coverage and getting help with costs
If you’re enrolled in Medicaid and will soon have Medicare eligibility, it’s not too soon to start planning ahead. Once Medicare eligibility begins, you’ll have a 7 month Initial Enrollment Period to sign up. For most people, this is 3 months before, the month of, and 3 months after their 65th birthday.
Once you have Medicare and Medicaid coverage, Medicare will cover your Part D prescription drugs and you’ll automatically qualify to get Extra Help paying for your drug costs. If you have limited income and resources, you may also qualify for help paying for your Medicare Part B premium and other Medicare costs, like deductibles and coinsurance. Medicare and your state Medicaid program work together to provide you with this help, called the Medicare Savings Programs.
The 4 Medicare Savings Programs (MSPs)
If you have income from working, you may qualify for these 4 MSPs, even if your income is higher than the income limits listed below. Each program has a different income and resource eligibility limit. Even if you don’t qualify for Medicaid, you may qualify for one of these programs to help you cover your Medicare costs.
- Qualified Medicare Beneficiary (QMB) Program
- Specified Low-Income Medicare Beneficiary (SLMB) Program
- Qualifying Individual (QI) Program
- Qualified Disabled and Working Individuals (QDWI) Program
How do I apply for Medicare Savings Programs?
If you answer yes to these 3 questions, call your State Medicaid Program to see if you qualify for a Medicare Savings Program in your state:
- Do you have, or are you eligible for, Part A?
- Is your monthly income for 2015 at, or below, $1,333 (single) or $1,790 (married or living together)?
- Do you have limited resources, less than $7,160 (single) or $10,750 (married or living together
It’s important to call or fill out an application if you think you could qualify for savings—even if your income or resources are higher than the amounts listed here.
What items are included in the Medicare Savings Program resource limits?
Countable resources include:
- Money in a checking or savings account
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
- Other household and personal items
How can I keep my costs down?
- Make sure your Medicare card is valid and that you’ve paid your Part B premium.
- Go to a doctor, other health care provider, or supplier that accepts assignment.
- Read about how to get help with medical and prescription drug costs.
Filed under: Medicare coverage, Uncategorized