As Americans and as Alaskans, we share in the health care program costs of our Medicare, both through our federal income taxes and through the cost sharing paid by individuals enrolled into Medicare. But for some Alaskans with low income and low assets, these costs can be a significant part of the monthly budget – there are programs which can help save you money.
In this month’s article, I will introduce the Medicare Savings Program (MSP), which can help with the bills for Original Medicare (as Parts A & B) along with describing the Extra Help program, which does the same for your Medicare Prescription Drug Plan (PDP, under Part D).
Medicare Savings Program
For Alaskans with low income and low assets who have enrolled into Medicare, the Medicare Savings Program (MSP) can significantly help manage your costs. The State of Alaska’s Division of Public Assistance manages the MSP; Alaskans request enrollment into the MSP by submitting the Application for Services (form GEN-50C). This year, the income limit is $2,137 per month (single) or $2,894 (couple), while the asset limit is $9,430 (single) or $14,130 (couple); assets do include your savings, checking and invested accounts, but do not count the value of your home or your car. Covered costs normally include the premium for your Part B outpatient services. This can save you $174.70 each month.
If your income and assets values are even lower, then your reduced expenses will also include Medicare cost sharing (co-pays, co-insurance) along with your deductible and the premium for Part A inpatient services (for those who may be ineligible for premium-free Part A, such as if your work history is less than a combined ten years). The category of this MSP is known as a Qualified Medicare Beneficiary (QMB). To qualify, your monthly income limit is $1,588 (single) or $2,149 (couple) and your asset limit of $9,430 (single) or $14,130 (couple). Once eligible for Medicare, and if your countable assets are no more than $2,000 then you will likely qualify to simultaneously be enrolled into Medicaid for Aged, Blind and Disabled (ABD) individuals.
Extra Help for your Prescription Drug Plan (PDP)
Once you have enrolled into a Medicare Part D Prescription Drug Plan (PDP), then you may be eligible to save on your out-of-pocket costs through a federal program called Extra Help. This program is managed by the Social Security Administration. You may be automatically enrolled in certain circumstances, or you may qualify if your income limit is $2,371 (single) or $3,212 (couple), and your asset limit is $17,220 (single) or $34,360 (couple). As with the MSP, assets do include your savings, checking, and invested accounts, but do not count the value of your home or your car.
Extra Help is not a replacement for your Part D PDP; rather this program is a low-income subsidy which offers specific benefits to help lower your costs.
Under Medicare’s Part D, your PDP is offered by an insurance company, which has contracted with both drug manufacturers (pharmaceutical companies) and drug distributors (pharmacy networks). When choosing the best PDP, your goal is to meet your specific medical needs and to also offer the lowest overall costs, as a combination of your annual deductible, monthly premiums, and the co-pays when you pick up your prescriptions from an in-network pharmacy during the calendar year. Extra Help helps by lowering the costs of your prescription drugs, reducing the cost of premiums (for specific plans), eliminating a previously incurred late enrollment penalty, and offering special enrollment periods (once per quarter, during the first nine months of the calendar year).
To discuss these cost saving programs, or to ask any questions regarding your specific situation, please contact the State of Alaska Medicare Information Office at 800-478-6065 or 907-269-3680; our office is also known as the State Health Insurance Assistance Program (SHIP), the Senior Medicare Patrol (SMP), and the Medicare Improvements for Patients and Providers Act (MIPPA) program.
If you are part of an agency or organization that assists seniors with medical resources, consider networking with the Medicare Information Office. Call us to inquire about our new Ambassador program.
Sean McPhilamy is a volunteer and Certified Medicare Counselor for the Alaska Medicare Information Office.
