Medicare Assistance Programs
- If your loved one cannot afford Medicare premiums, help is available in the form
of several types of Medicare Savings Programs.
- Veterans may qualify for additional health benefits that can help cover the costs
of care.
- All-inclusive programs called PACE may be a better choice than a nursing home for
your loved one.
Next Step
Contact your State Health Insurance Assistance Program (SHIP) or Department of Social
Services to learn about or apply for Medicaid and other programs.
Medicare Savings Programs
Medicare Savings Programs, also known as Medicare Buy-In programs, help pay for
Medicare costs. If your loved one is on a limited income, he or she may able to
get assistance in paying for Medicare Part B premiums and additional benefits through
Medicaid. To find out if your loved one might qualify for one of the Medicare Savings
Programs below, contact your State Health Insurance Assistance Program (SHIP) office.
Qualified Medicare Beneficiary Program (QMB)
This state program pays for Medicare premiums and may pay for some or all of the
deductibles and coinsurance. To qualify, your loved one must have limited savings
(in 2007, up to $4,000 for individuals, $6,000 for couples) and income (up to $851
a month for individuals, $1,141 a month for couples).
Specified Low-Income Medicare Beneficiary Program (SLMB)
This program pays for Medicare Part B premiums for those with limited savings and
an income between 100 and 120 percent of poverty.
Qualifying Individual Program (QI-1)
For those whose income is 120 to 135 percent of poverty and whose assets are limited,
this program pays for Medicare Part B premiums.
Veterans Benefits
If your loved one qualifies for health benefits from the Department of Veterans
Affairs (VA), he or she can receive both Medicare and VA benefits, but they don’t
work together. Medicare doesn’t pay for any care provided at a VA facility--the
only place VA benefits are offered. Many veterans use their benefits to get services
not covered by Medicare, such as prescription drugs. For more about eligibility
and benefits, call the VA Health Administration Center at 1-800-733-8387 or 1-877-222-8387.
Medicaid
If your loved one has limited assets and income, he or she may be eligible for Medicaid.
Costs covered by Medicare are paid for by Medicare first;
Medicaid picks up where Medicaid leaves off.
Programs of All-Inclusive Care for the Elderly (PACE)
Offered through Medicare and Medicaid in certain states, these programs combine
medical, social, and long term care services. PACE programs allow recipients to
remain at home while receiving all medically necessary services, including prescription
drugs. Contact your state’s SHIP office to learn more.
Next Step: Contact your State Health Insurance Assistance Program (SHIP) or Department of Social
Services to learn about or apply for Medicaid and other programs.
