Abby is 92 years old and has Original Medicare. She needed help paying for her Medicare Part B and applied for a Medicare Savings Program (MSP). A few months later, she received a letter saying she qualified for the Qualified Individual (QI) program, which pays the Part B monthly premium. Although Abby thought she had the benefit, Social Security continued to deduct the Part B premium from her monthly check over the course of the following year.
What should Abby do to fix her MSP?
What To Do:
Abby should contact her local Medicaid office. They will be able to help her find out about the status of her MSP and ensure her application was processed correctly.
Abby has a protected filing date, which means that the Medicaid office should treat her application as if it were properly handled when she first submitted it. Abby is entitled to benefits from the time when that application was initially submitted, even though her Part B premiums continued to be deducted after she was approved for QI.
Once the problem is corrected at the Medicaid office, Abby should receive a check for past Part B premiums that the QI program should have covered, and the monthly Part B premium should no longer be deducted from her Social Security check going forward.
What is a Medicare Savings Program?
MSPs are assistance programs that help pay Medicare costs if you have limited income and assets. They are usually run through your state Medicaid program.
There are three main programs:
- Qualified Medicare Beneficiary (QMB): Pays for Medicare Parts A and B premiums. If you have QMB, typically you should not be billed for Medicare-covered services when seeing Medicare providers or providers in your Medicare Advantage Plan’s network.
- Specified Low-income Medicare Beneficiary (SLMB): Pays for Medicare Part B premium.
- Qualifying Individual (QI) Program: Pays for Medicare Part B premium.
Being enrolled in an MSP will also automatically enroll you into the federal Extra Help program, which helps pay for Part D prescription drug plan costs.
Each state has different eligibility requirements for the MSPs. Contact your State Health Insurance Assistance Program (SHIP) or your local Medicaid office for information about eligibility and applications.