Where to get help paying your Medicare costs
Last updated 7/19/2019 at Noon
Dear Savvy Senior,
Are there any sources you know of that can help me save on my Medicare coverage? I’m 65, and live primarily on my Social Security, and am having a hard time paying my Medicare out-of-pocket costs.
Need Some Help
There are several financial assistance programs that can help lower-income Medicare beneficiaries who are having a difficult time paying their out-of-pocket health care costs. Here’s what’s available, along with the eligibility requirements and how to apply.
Medicare Savings Programs
Let’s start with a program that helps 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 based on their income and asset level. At its most generous the program will pay your Part A and B premiums and pretty much all your Medicare deductibles, coinsurance and copayments. 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 $1,426 a month for individuals (or $1,923 for married couples). 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 $7,730 per individual ($11,600 for married couples), 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 state Medicaid program. Visit Medicare.gov/contacts#or call all 800-633-4227 for contact information.
Medication Extra Help
For help with Medicare (Part D) 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 how low your income is, this program will pay part or all of your Part D prescription drug plan’s monthly premiums, annual deductibles and prescription co-payments. In 2019, individuals with a yearly income below $18,735 ($25,365 for a married couple), and assets under $14,390 ($28,720 for a married couple) can qualify for Extra Help.
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, visit SSA.gov/extrahelp or call Social Security at 800-772-1213.
Other Assistance Programs
Depending on your income level, needs and location there are many other financial assistance programs that can help like Medicaid, SSI (Supplemental Security Income), PACE (Program of All-inclusive Care for the Elderly), SNAP (Supplemental Nutrition Assistance Program), (LIHEAP) Low Income Home Energy Assistance Program and many others.
To help you find out what types of assistance programs you may be eligible for, and learn how to apply for them, go to BenefitsCheckUp.org. This is a free, confidential Web tool designed for people age 55 and older that contains more than 2,500 programs.
It’s also possible to get help in person at one of the 87 Benefits Enrollment Centers scattered across the U.S. Call 888-268-6706 or visit NCOA.org/centerforbenefits/becs to locate a center in your area. Some centers also offer assistance over the phone.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.