Medicare Cost-Saving Programs: Do You Qualify?

Medicare provides essential healthcare coverage, but out-of-pocket costs like premiums, deductibles, and copayments can add up quickly. Fortunately, there are several Medicare cost-saving programs designed to help low-income beneficiaries reduce their expenses. If you’re struggling to afford Medicare, you may qualify for financial assistance through these programs.

1. Medicare Savings Programs (MSPs)

Medicare Savings Programs (MSPs) are state-administered programs that help eligible individuals cover Medicare costs. There are four types of MSPs:

Qualified Medicare Beneficiary (QMB) Program

✅ Helps pay for Part A & Part B premiums, deductibles, copayments, and coinsurance.✅ You cannot be billed for Medicare-covered services by participating providers.✅ Monthly income limit (2024):

• Single: $1,235

• Married: $1,663

Specified Low-Income Medicare Beneficiary (SLMB) Program

✅ Pays for Part B premiums only.✅ Monthly income limit (2024):

• Single: $1,478

• Married: $1,992

Qualifying Individual (QI) Program

✅ Pays for Part B premiums (funding is limited and granted on a first-come, first-served basis).✅ Monthly income limit (2024):

• Single: $1,660

• Married: $2,239

Qualified Disabled and Working Individuals (QDWI) Program

✅ Pays for Part A premiums for working disabled individuals under 65.✅ Monthly income limit (2024):

• Single: $5,015

• Married: $6,782

  
  

2. Extra Help for Prescription Drugs (Low-Income Subsidy - LIS)

The Extra Help program assists with Medicare Part D prescription drug costs. Benefits include:

• Lower or no monthly premiums

• Reduced copayments for medications

• No Part D late enrollment penalty

Eligibility Requirements (2024)

• Single: Income below $22,590/year and assets below $17,220.

• Married: Income below $30,660/year and assets below $34,360.

To apply, visit SSA.gov or call 1-800-772-1213.

3. Medicaid & Medicare Dual Eligibility

Some individuals qualify for both Medicare and Medicaid (dual eligible), which provides additional cost-saving benefits, including: ✅ Full or partial Medicaid coverage for healthcare costs.✅ Medicare premiums and out-of-pocket costs covered by Medicaid.✅ Access to Medicare-Medicaid Plans (MMPs) for streamlined benefits.

To check eligibility, contact your state Medicaid office.

4. State Pharmaceutical Assistance Programs (SPAPs)

Some states offer SPAPs to help pay for prescription drugs, either in addition to Medicare Part D or as standalone assistance. Each state has its own eligibility criteria and coverage.

Visit Medicare.gov to check if your state offers an SPAP.

5. Programs of All-Inclusive Care for the Elderly (PACE)

PACE is a Medicaid and Medicare program for individuals 55+ who require nursing-home-level care but want to remain at home. PACE provides:

• Medical services, prescription drugs, and personal care.

• Transportation to medical appointments.

• Social support and therapy services.

Eligibility varies by state, and you must live in an area where PACE operates.

How to Apply for Medicare Cost-Saving Programs

Applying for financial assistance is easier than you think! Follow these steps:

1️⃣ Visit Your State Medicaid Office – Check eligibility and apply for MSPs or Medicaid. 2️⃣ Apply for Extra Help – Visit SSA.gov or call 1-800-772-1213. 3️⃣ Check State-Specific Assistance – Look for SPAPs or PACE programs in your area. 4️⃣ Get Expert Help – Contact Lindbergh and Associates for a free consultation on Medicare savings options.

Final Thoughts

If Medicare costs feel overwhelming, don’t worry—help is available! These programs are designed to ensure that all beneficiaries, regardless of income, can access the healthcare they need.

Want to see if you qualify? Lindbergh and Associates can guide you through the process and find the best cost-saving solutions for your Medicare coverage.

📞 Call us today or schedule a consultation online to start saving on Medicare expenses!