Medicare is federally funded health insurance for seniors and the disabled. Many Medicare beneficiaries purchase supplemental coverage, like Medigap policies, to help ease the not-insignificant, out-of-pocket costs associated with Medicare. The supplemental coverage itself can be expensive too, though. Fortunately, there is help available for low-income Medicare beneficiaries that lowers Medicare costs, freeing funds to purchase supplemental coverage. There is significant help available for all medical costs for the very impoverished.
Medicare Help
If your income and assets are limited and you have Medicare Part A (hospitalization) or Part B (other medical coverage), you may qualify for extra help. If you meet the guidelines to be a Qualified Medicare Beneficiary (QMB), you'll receive help with Part B premiums and Medicare's co-pays and deductibles, essentially eliminating the need for a Medigap. As of 2011, the QMB income limit is $928 for an individual and $1,246 for a couple. Specified Low-Income Medicare Beneficiaries (SLMB) and Qualifying Individuals (QI) receive help with Part B premiums, freeing up $100 or more per month that can be put toward supplemental coverage. The SLMB income limits as of 2011 are $1,109 for an individual and $1,491; for QI the limits are $1,246 for an individual and $1,675 for a couple. Specific qualification guidelines are subject to change; you can call Medicare or visit your local social services office for more information.
Medigap Options
Medigap policies are federally regulated health insurance policies designed specifically to work with Medicare. Plans are standardized, so a Plan N with one company has the same benefits as a Plan N with another company. Some plans may be too expensive for someone with a limited income but there are a few less expensive choices. Plans K, L, M and N are specifically designed to be less expensive. Plans K, L and M have cost sharing, where you pay a percentage of Medicare's out-of-pocket costs in exchange for a lower premium. Plans K and L also have an out-of-pocket limit. Plan N has a co-pay for doctors visits, which also lowers the premium.
Medicare Advantage Plans
Medicare Advantage plans are an alternative to Medicare supplements. Typically, the premiums are significantly less expensive but there are co-pays and deductibles to contend with. Medicare Advantage plans may also include prescription coverage. Medicare Advantage plans take the place of original Medicare but you are still considered a Medicare beneficiary. There are typically several plans to choose from in any given region and the plans are not standardized, so it's important to review the potential overall costs of the plan.
Extra Help Prescription Costs
Medicare Part D is Medicare's prescription program offered through private companies. There is Extra Help available for Part D beneficiaries; qualifying is dependent on your income and assets and you apply through Social Security. You may receive help with your plan's premiums or out-of-pocket costs or both. To apply, contact Social Security. This extra help can free funds for a Medigap or lower premiums for a Medicare Advantage plan.
Medicaid
Medicaid is for truly impoverished individuals. If you qualify for Medicaid, your health costs are, for the most part, covered except for a small co-pay. Medicare is your primary coverage and Medicaid becomes secondary. This eliminates the need for a Medigap policy. You shouldn't purchase one if someone tries to sell one to you. To apply, contact your local social services office.
Tags: Medicare Advantage, supplemental coverage, help with, less expensive, Medicare Advantage plans, out-of-pocket costs, receive help
