Want to save more on your Medicare health plan?
You may be eligible for Medicare Savings Programs (MSPs).
Although Medicare is often more affordable than other health insurance options, did you know that if you qualify, you may not have to pay for some parts of Original Medicare (Parts A and B)? Medicare Savings Programs (MSPs) are government programs that help lower Medicare costs for people who qualify because of lower incomes and limited savings.
Each program is a little different, but in general, these programs can help cover your Medicare Part B premiums, as well as copays and coinsurance for the care you receive, if you qualify. Some people may even qualify for additional benefits covered by the state.
Who is eligible for the Medicare Savings Program (MSP)?
There are two main requirements to qualify for a Medicare Savings Program.
Your resources
This includes how much money you have in the bank or in retirement accounts, such as an IRA. The value of your home and personal belongings is not included
Your monthly income
If your income is less than 135% of the Federal Poverty Level, you may qualify. It is important to note that if you are working, you may still qualify for one of the Medicare Savings Programs. A Federal Program To Help Lowe
Types of Medicare Savings Programs (MSPs)
“Extra Help” Program (Low-Income Supplement) to lower your prescription drug costs
The costs of prescription drugs (Part D) can be very high. Depending on your income and resources, you may qualify for "Extra Help," also called Low Income Supplement (LIS). Extra Help helps you pay for your prescription drug costs, like your monthly Part D premium, your deductible, and your drug costs.
You may automatically get "Extra Help" if:
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You qualify for a Medicare Savings Program and get help paying your Part B premium
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Have Medicare and Medicaid
Some Medicare Advantage plans (Part C) will help you pay your Part B premium.
If you are enrolled in Original Medicare (Parts A and B) , you may be able to choose a Medicare Advantage Plan (Part C) that will help you pay part of your Part B premium.
You are only eligible for this benefit if:
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You are enrolled in Parts A and B
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Choose a Medicare Advantage plan (Part C) that offers the rebate benefit of Part B.
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You pay your own Part B premium. You won't qualify if you get help from the government to pay your Part B premium.
Are you eligible for Medicare and Medicaid?
If you qualify for both Medicare and Medicaid, then you may be eligible to enroll in a special type of Medicare Advantage Plan (Part C) called a Dual-Eligible Special Needs Plan (D-SNP). With this type of plan, you will get additional benefits and save money on your copays and other out-of-pocket costs.
What is Extra Help from Medicare?
Medicare offers “Extra Help” to pay for prescription drug costs for people with limited income and resources. The resources are your savings and your stocks, but not your house or your car. If you qualify, you'll get help paying for any Medicare drug plan's monthly premium, your yearly deductible, and drug copays. This extra help will be applied toward your out-of-pocket costs.
How do I qualify for Extra Help?
Here are some ways to qualify for Extra Help:
- If you receive full Medicaid benefits, you automatically qualify for Extra Help. You do not need to apply separately. Medicare will mail you a letter with information about Extra Help when you qualify.
- If you receive any help from Medicaid to pay your Medicare premiums or receive Supplemental Security Income, you will automatically receive Extra Help and do not need to apply separately. However, you will need to enroll in a Medicare prescription drug plan.
- If you have limited income and resources and don't get help from Medicaid, you can apply for Extra Help and join a Medicare drug plan 1. Call 1(800) MEDICARE, 24/7 (except for some federal holidays) (TTY-2048).
How do I show that I am eligible for Extra Help?
The Centers for Medicare & Medicaid Services (CMS) initiated the Best Available Evidence (BAE) policy to manage eligibility for Extra Help. The BAE makes sure that people who get Extra Help aren't overcharged or have higher copays than they should.
According to CMS, all plan sponsors, such as Cigna, must accept the BAE submitted by someone applying for Extra Help if that person is eligible, even if Medicare records do not show it. When you have submitted the Best Available Evidence to Cigna Medicare, we will ask CMS to change your status in the system.
Some acceptable forms of Best Available Evidence are:
- A copy of your Medicaid card (if you have one)
- A copy of a state document showing you have Medicaid
- A printout from a state electronic enrollment file or from your state's Medicaid systems showing you have Medicaid
- A screen print from the state Medicaid systems showing your Medicaid status
- Any other documents from your state that show you have Medicaid
- A document from your state showing you have Medicaid and are receiving home and community-based services
- Award Letter from the Social Security Administration (SSA)
- A copy of the application for eligibility consideration “Application Filed by Deemed Eligible” (SSA Publication HI 03094.605), which confirms that the beneficiary is “automatically eligible for extra help”
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