Medicare Advice If You Have Lower Income

Many Medicare beneficiaries worry as they get close to age 65 about the Medicare part B premium; after all, if you are already collecting social security, Medicare will deduct the Part B Premium (which as of 2024 is $174.70 per month) directly out of your check, and if you are on a fixed income this can be bad news! This is why many veterans opt NOT to have Part B (read our article here as to why we recommend veterans have it).

But, did you know that lower income Medicare beneficiaries may be eligible for significant financial help?

There is a program called the Medicare Savings Plan that every state has (some states may call it something else). Essentially, if you are earning below the federal threshold of 135% of the Federal Poverty Level (about $1,700 per month) then you may be eligible for this program. Note, this program typically INCLUDES ALL SOURCES OF INCOME, even if it is not taxable

IF approved, the state will pay your Part B Premium. You will also be enrolled in the Federal Low Income Subsidy Program to help cover costs of Medications and lower your copayments

Being approved for the Medicare Savings Program will open up an entire category of plans available to you that you were not eligible for before that will ease your financial burden

What to do if your income is too high

If your income is too high for the Medicare Savings plan by just a little, some states will still approve you. You will have what is called a "spend down" limit, which is pretty confusing. But basically, you will have the plan and your Part B premium will taken care of, but may have some copayments still, whereas those below the threshold generally have no copayments

What is the benefit of the Medicare Savings Plan?

As a beneficiary of the Medicare Savings Plan, you will be able to access programs called D-SNP (or Dual Eligible - Special Needs Plans)

This means you are eligible for BOTH Medicare and Medicaid

You will still have Medicare A and B, but the State will handle your Part B premiums, along with any copayments and coinsurances you may face. And if you choose to enroll in a D-SNP plan, you will have even more benefits, such as a monthly spendable card that can be used for food, utilities, and over the counter items. In some places, this monthly benefit can exceed $200-250 per month for you to spend however you need.

It's important to note: Medicare Savings Plans approval can take time depending on the state, sometimes it can take a few days, upwards of a few weeks. Slower states can take a couple of months. During this time, you will be paying the full cost of the Medicare Part B premium (BUT, you can enroll in a Plan to reduce the cost significantly for you). Once approved for the Medicare Savings Plan, you will be reimbursed for your Part B premium expenses for a few months prior.

There are a lot of moving parts to these plans and programs, which is why it's important to speak to a trusted expert who can help you navigate the plans, submit the correct paperwork, and help ease your financial burden. Reach out to us today to see if we can help!