The federal Medicare program provides essential health coverage for eligible people 65 years of age or older and those younger than 65 with a disability. It is a critical program that covers more than 64.2 million Americans. Yet, Medicare can be expensive, has out-of-pocket costs, and needs supplement coverage to help cover the gaps. It is not universal coverage. This challenge can be a hardship for many Medicare beneficiaries who struggle to get by. In fact, half of our country’s Medicare beneficiaries had income below $29,650 in 2019, and one in four was living on less than $17,000, according to the Kaiser Family Foundation. In 2020, 45% of men and 54% of women living alone lacked the resources to pay for their basic living needs, according to the University of Massachusetts’ Elder Index, which measures the typical cost of living for older people for every county in the United States. With these challenges and struggle to meet basic living needs, the Medicare Savings Programs (MSP) and Part D’s Extra Help program could help a lot of people.
What are the Medicare Savings Programs?
The Medicare Savings Programs help pay Medicare premiums and/or cost-sharing for qualified Medicare beneficiaries with incomes and assets below certain levels (up to 135% of the federal poverty level). It is run by state Medicaid programs (Medi-Cal in California). This year, the income level is up to $18,347 for individuals and $24,719 for couples. The asset limits are $8,400 for individuals and $12,600 for couples, though they will increase to $130,000 for individuals and $195,000 for couples as of July 1, 2022.
With Medicare Part B’s premium alone raising almost 15% in 2022 to $170.10/month, the Medicare Savings Programs can literally save lives for people that are going without food or medicine to help cover their basic expenses. Also, in most cases, people who are eligible for a Medicare Savings Program (MSP), also qualify for full Medi-Cal (California’s Medicaid program), which includes long-term care, vision and dental benefits.
What is the Part D Extra Help?
The Part D Extra Help program pays for a portion of Part D prescription drug plan costs, including Part D premiums, deductibles and copayments. Depending on a person’s income and assets, they may qualify for the full subsidy or a partial subsidy. The assistance varies according to income level — up to $20,385 for individuals and $27,465 for couples this year. The asset limit is $14,010 for individuals and $27,950 for couples.
How do I apply and where can I go for help?
- Medicare Savings Programs – For the MSPs, you can contact your local Health Insurance Counseling and Advocacy Program (HICAP). They provide free, individual assistance with Medicare and Medi-Cal issues, and can help screen you for MSP eligibility and help with enrollment. If you live outside of California, you can contact your local State Health Insurance Assistance Program (SHIP).
- Part D Extra Help – For the Extra Help program, you can also contact your local HICAP. Or apply online directly at the Social Security Administration website or by calling 800-772-1213. You can also apply by visiting your local Social Security office.
