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Programs that Help Seniors with Health Care Costs
Assistance programs that can help Medicare beneficiaries who are having a tough
time paying their out-of-pocket health care costs. Here’s what’s
offered, along with the eligibility requirements and how to apply.
Let’s start with a program that helps lower-income Medicare beneficiaries
pay premiums and out-of-pocket costs for Medicare Parts A and B. It’s called
the Medicare Savings Program (MSP), and it has several different benefit levels
for people with different financial resources. At its most generous the program
will pay your Part B premium and pretty much all your Medicare deductibles and
coinsurance. At its least generous the program will pay just your Part B premium.
To qualify for a MSP, the minimum standard set by Medicare, is an income under
135 percent of the federal poverty level, which at the moment works out to around
$1,313 a month for individuals. Everything counts towards income, including payouts
from 401(k) plans, pensions, Social Security, and help from family members. Medicare
also allows states to impose an asset test, which can be as little as $7,080
per individual, not counting your house or car but counting retirement savings
and bank accounts.
But some states have made their MSP programs a lot more generous, with much higher
income limits and in some cases no asset tests at all. And the program may be
called something else in your state. To find out if you qualify or to apply,
contact your local Medicaid office – call 800-633-4227 for contact information.
For help with your Medicare prescription drug plan costs, there is another completely
separate program called Extra Help. To get it, you’ll need to apply through
your local Social Security office.
Depending on exactly how low your income is, the program will pay all or part
of your Part D prescription drug plan premium and deductible, a hefty chunk of
your copay, and totally eliminate the doughnut hole coverage gap. In 2013, individuals
with an income below $1,436 a month, and assets under $13,300 can qualify for
If you’re eligible to be in a Medicare Savings Program, you will automatically
qualify for Extra Help. But because the requirements are slightly different,
even if you don’t qualify for a Medicare Savings Program for Part B you
might be able to get Extra Help for Part D. For more information or to apply,
call Social Security at 800-772-1213 or visit socialsecurity.gov/prescriptionhelp.
To help you find out if you’re eligible for these programs, use the National
Council on Aging web-based tool at benefitscheckup.org. You’ll need to
fill out an online questionnaire that asks things like your date of birth, zip
code, expenses, income, assets and a few other things. Once completed you’ll
get a report detailing which programs you may qualify for, along with downloadable
application forms and, in the case of Extra Help, allow you to complete your
entire application online. The program even knows the specific MSP eligibility
rules in your state.
Or, if you don’t have Internet access, contact your State Health Insurance
Assistance Program (SHIP), who provides free one-on-one Medicare counseling in
person or over the phone. To locate your local SHIP, call the eldercare locator
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