Medicare Savings Programs (MSPs) help pay your Medicare costs if you have limited income and savings. Additional benefits of enrolling in an MSP include:
- Allowing you to enroll in Medicare Part B Part B, also known as medical insurance, is the part of Medicare that covers most medically necessary doctors’ services, preventive care, hospital outpatient care, durable medical equipment (DME), laboratory tests, x-rays, mental health services, and some home health care and ambulance services. outside of usual enrollment periods Enrollment periods are certain periods of time when you can join the Original Medicare program, or enroll in a Medicare Advantage Plan, Part D plan, or supplemental insurance plan (Medigap). See also: Fall Open Enrollment, Medicare Advantage Open Enrollment Period, General Enrollment Period, Initial Coverage Election Period, Initial Enrollment Period, Medigap Open Enrollment Period, and Special Enrollment Period.
- Eliminating your Part B late enrollment penalty A late enrollment penalty is an amount you must pay to Medicare in addition to the regular monthly premium for late enrollment in Part B or Part D. The Part B premium penalty is 10% of the Part B premium for each 12-month period you delayed enrollment without insurance from your or your spouse’s current work. The Part D premium penalty is 1% of the Part D premium for each month you delayed enrollment without creditable drug coverage. , if you have one
- Automatic enrollment in the Extra Help Extra Help, also known as the Part D Low-Income Subsidy (LIS), is a federal program administered by Social Security that helps pay for some to most of the out-of-pocket costs of Medicare prescription drug coverage, including coinsurances, deductibles, and premiums. People with Medicare who have income and assets below specified limits are eligible for Extra Help, which has different levels. Depending on your income and assets, you may qualify for either full Extra Help or partial Extra Help. People may also be automatically enrolled in Extra Help if they have certain other types of coverage, even if their income and assets are above the set levels. program
There are three main MSPs, each with its own eligibility criteria:
- Qualifying Individual (QI) Qualifying Individual (QI) is a Medicare Savings Program (MSP) administered by each state’s Medicaid program. It pays the Medicare Part B premium for people with Medicare who have limited income and assets.
- Specified Low-Income Medicare Beneficiary (SLMB) Specified Low-Income Medicare Beneficiary (SLMB) is a Medicare Savings Program (MSP) administered by each state’s Medicaid program. It pays the Medicare Part B premium for people with Medicare who have limited income and assets.
- Qualified Medicare Beneficiary (QMB) Qualified Medicare Beneficiary (QMB) is a Medicare Savings Program (MSP) administered by each state’s Medicaid program. It helps people with Medicare who have limited income and assets pay their premiums, deductibles, and coinsurances. If you have QMB, you should not be billed for any Medicare-covered services you receive from Original Medicare providers or providers in your Medicare Advantage Plan’s network.
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Get Help Applying for Medicare Cost-Savings Programs
If you live in New York, the Medicare Rights Center can help you enroll in various Medicare cost-savings programs. Please answer a few questions to see if we can connect you with a trained benefits enrollment counselor.
Contact your local State Health Insurance Assistance Program
Each state offers a SHIP, partly funded by the federal government, to give you free counseling and assistance. A SHIP counselor may be available by phone or in person.
Visit www.shiptacenter.org to find your local SHIP office.
Contact your local State Health Insurance Assistance Program
Based on the information you provided, you do not appear to be eligible for Medicare cost-saving programs.
[glossary_exclude]Each state offers a State Health Insurance Assistance Program (SHIP), partly funded by the federal government, to give you free counseling and assistance. A SHIP counselor may be available by phone or in person.[/glossary_exclude]
Visit www.shiptacenter.org to find your local SHIP office.
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MSPs have income and asset limits, which vary by state. Call your local Medicaid office or State Health Insurance Assistance Program (SHIP) for more information about MSPs in your state and for help applying. After enrolling in any of the three programs above, you should receive premium-free Part B. Your premium-free Part B effective date is the same day as your MSP effective date.
Note: To use the MSP to enroll in Part B, you must currently have Part A Part A, also known as hospital insurance, is the part of Medicare that covers most medically necessary hospital inpatient care, skilled nursing facility (SNF) care, home health care, and hospice care. , unless you qualify for QMB. If you do not currently have Part A, you should enroll before applying for an MSP.
You should be sent an MSP decision notice from your local Medicaid office within 45 days of filing an application. The notice will tell you if your MSP application is approved or denied. If you are approved, it may take three to four months before your benefits take effect—but you should receive the MSP and premium-free Part B retroactive to the effective date on your decision notice.
Case example
In mid-May, Mr. A went to his local Medicaid office and applied for an MSP. He received an approval letter for SLMB at the start of July (approximately 45 days later), stating that his benefit would be retroactive to February (Note: SLMB is three months retroactive from the date of application). He finally received his SLMB enrollment documentation in October, and shortly after this, he received his Medicare card Everyone who enrolls in Medicare receives a red, white, and blue Medicare card. It lists your name and the dates that your Original Medicare hospital insurance (Part A) and medical insurance (Part B) began. It also shows your Medicare number, which serves as an identification number in the Medicare system. If you get Medicare through the Railroad Retirement Board, your card will say “Railroad Retirement Board” at the bottom. If you are enrolled in a Medicare Advantage Plan, you will also have a card from that plan (see Medicare Advantage Plan Card). with a premium-free Part B effective date of February.
It does not matter that Mr. A’s SLMB benefit was not fully processed until October: the original correspondence he received states that the benefit is retroactive to February, and so is his premium-free Part B coverage. Medicare should pay for Part B-covered services received any time after the Part B effective date. Mr. A’s providers can collect these payments by submitting claims to Medicare for past services. If Mr. A has paid Part B premiums between May and October, he should be reimbursed for them by the Social Security Administration.