What Are Medicare Savings Programs?
At last count, in 2023, there were over 65 million Americans enrolled in the federal healthcare program Medicare. There are additional people qualifying for and enrolling in Medicare every day. It is an extremely valuable program that helps to ensure that some of the most vulnerable populations have the access to healthcare that they need. However, it is not a perfect program, and, despite its subsidization by the government, there are out of pocket costs (OOP costs) associated with Medicare. Most people will not have to pay a premium for Part A (hospital insurance), but the majority of enrollees will pay a premium for Part B, which is medical insurance. There are also copayments, deductibles, and coinsurance. All of these costs can add up quickly, particularly if a beneficiary has chronic health issues. What Are Medicare Savings Programs?
That’s why there are Medicare Savings Programs. Medicare Savings Programs are special benefit programs. State Medicaid agencies sponsor these programs. They are designed to help adults who have limited assets and income by relieving some of the out of pocket expenses associated with Medicare.
MSP Levels
There are four different Medicare Savings Programs (MSPs) that help to cover premiums, deductibles, coinsurance, and copayments.
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Qualified Medicare Beneficiary (QMB): This program helps to pay for Part A premium and Part B premium. It also covers deductibles, coinsurance, and payments.
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Specified Low-Income Medicare Beneficiary (SLMB): This program helps pay for Part B premium.
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Qualifying Individual (QI): This also helps pay for Part B premium.
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Qualified Disabled Working Individual (QDWI): This helps pay for Part A premium.
Beneficiaries cannot choose the program that they want to enroll in. Rather, they will be assigned to the program that most closely matches their assets and income, as well as other details that the enrollee provides on their application. The guidelines for who qualifies for which program differ by state.
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