Help Paying for Medicare in Massachusetts
Article published in Northampton Living
(September 2024)
EXPERT CONTRIBUTOR
ERICA BEAUDRY
Medicare Advisor
EA Financial Solutions
413 626 9906
info@eafinancialsolutions.com
www.eafinancialsolutions.com
Medicare Savings Programs (MSPs) are federally funded programs administered by individual states. In Massachusetts, MassHealth is the administrator of these programs.
MSPs are not insurance plans: They are programs designed to help lower the costs of your Medicare insurance coverage. They are always combined with Medicare and do not offer any additional coverage or services that Medicare does not provide.
In Massachusetts there are two levels of Medicare Savings Programs. When you apply, the state will tell you which level and program you qualify for.
QMB Program
The Qualified Medicare Beneficiary program helps pay for Part A and Part B premiums, deductibles, coinsurances and copayments for services and items Medicare covers. You will also receive Extra Help for your prescription drugs. With Extra Help you will pay no more than $11.20 for each drug covered by your Medicare Prescription Drug Plan.
SLMB/QI Program
The Specified Low-Income/Qualifying Individual Medicare Beneficiary Program helps pay for your Medicare Part B premium. Along with meeting the income guidelines, you are required to have both Medicare Part A and Part B to qualify. You will also receive Extra Help for your prescription drugs, paying no more than $11.20 for each drug covered by your Medicare Prescription Drug Plan.
Why Would I Want an MSP?
You may qualify for help paying your Medicare Part B monthly premium of $174.70 if your gross monthly income is at or below 225% of the federal poverty level in 2023. Currently the SLMB/QI program income limits are $2,824 per month for a single individual and $3,833 per month for a married couple.
These amounts are based on your total monthly income before any deductions.
Historically, in addition to income limits, there was an asset limit. This meant that many people who qualified based on their income were denied due to assets such as bank accounts or retirement savings. In March 2024 the Healey-Driscoll administration made changes to the guidelines; in addition to increasing the income levels to the aforementioned amounts, they removed the asset limit. This has resulted in far more people qualifying for assistance with their Medicare costs.
How Do I Apply?
The application for Medicare Savings Programs is simple and can be found online. However, working with a professional to help track your application and make sure it is properly received and processed is recommended because the correspondence can be a bit confusing. An independent advisor or local Serving the Health Insurance Needs of Everyone (SHINE) counselor can assist you with this process at no cost to you.
This is also a good time to conduct a Medicare coverage check-up with a professional because if you are approved for the program, you are allowed a Special Enrollment Period to make any desired changes to your current coverage. Whether you are new to Medicare or already enrolled, working with an independent advisor is a great way to get help understanding all the benefits you are entitled to and select the right plan for your individual situation.
Disclaimer: I do not work for and I am not affiliated with Medicare.
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