Learn How a Medicare Savings Program (MSP) Can Help You Save Money on Your Medicare Costs
Nearly all Americans are entitled to receive Medicare health insurance benefits at some point in their life, generally after they reach retirement age. However, though the Medicare program is taxpayer supported, it still obligates policyholders to pay for a certain portion of their medical care and benefits.
Still, many people struggle to afford regular costs like their Medicare benefits, and you must continue to pay your premiums if you want to remain a Medicare participant. That’s why, for low-income individuals, New York (and most other states) have instituted Medicare Savings Programs (MSPs) to help alleviate cost burdens on those who need payment relief the most.
Let’s take a closer look at MSPs, consider how they work, and gain a better understanding of how enrolling in this critical benefit can help you save a lot of money on your Medicare costs.
Understanding MSPs
Low-income individuals often cannot afford some of the basic necessities of life, health insurance included. However, because the Medicare system is designed to offer health benefits to all Americans, accommodations have been made to make policies even more affordable for those who could struggle under the cost burdens imposed by the plan.
-
Medicare Part A premiums (many people have a $0 premium, however)
-
Medicare Part B premiums (vary by income brackets)
-
Part A & Part B deductibles
-
Coinsurance & copayment costs imposed for different medical services
However, for low-income recipients, even these drastically reduced medical costs can seem like exceptional burdens. As a result, Medicare Savings Programs are available to help qualifying individuals continue to reduce their cost burden for care expenses. In New York, MSPs are administered by the state’s Medicaid program. However, they remain separate from Medicaid, and you are not required to purchase Medicaid in order to qualify for this benefit.
What are the Different Types of MSPs?
There are three primary types of MSPs available to New Yorkers. Each will cover different costs related to your Medicare expense burdens.
-
Qualifying Individual (QI) MSPs
-
Pays for your Part B premium
-
May receive up to three months retroactive reimbursement for Part B premiums (Note: only for premiums paid up to three months before your MSP effective date, and within the same year of that effective date)
-
You cannot have both QI and Medicaid
-
Specified Low-Income Medicare Beneficiary (SLMB) MSPs
-
Pays for your Part B premium
-
May receive up to three months retroactive reimbursement for Part B premiums
-
You can have both SLMB and Medicaid
-
Qualified Medicare Beneficiary (QMB) MSPs
-
Pays for Medicare premiums
-
Providers are prohibited from charging you for Medicare cost-sharing (deductibles, coinsurance, and copayments). This means 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
-
You can have both QMB and Medicaid
There are also Qualified Disabled and Working Individual (QDWI) MSPs.
These plans will work alongside both Original Medicare and certain Medicare Advantage plans. However, you must meet low-income requirements in order to qualify for each benefit. Still, if you exceed the income requirements for one MSP, you might still qualify for an alternative plan. Applicants are also entitled to appeal a decision and request a hearing regarding a denied MSP application.
Additionally, according to the Medicare Rights Center: New York disregards/excludes the cost of certain health insurance premiums from your income. For example, if you are over the income limit for an MSP but pay a premium for a Medigap or other secondary health insurance, you may deduct the premium from your gross monthly income to qualify. Sometimes a portion of your Part D premium can also be deducted from your income. The Part B premium ($148.50 deducted from your Social Security award) cannot be used as a disregard.
While it might seem complicated to apply for an MSP, the benefits will pay off in the long run. This program is designed specifically to make health care more accessible for those in low-income brackets, so that they never have to be without the care they deserve.
Source: Medicare Rights Center
Tags: Medicare