How to Get Help with Medicare Premiums, Deductibles and Coinsurance

If you are struggling with paying for Medicare Part B, or if you are putting off having a healthcare issue checked out by your physician because you haven’t met the deductible for your Medicare, or if you can’t afford a supplement for your Medicare, then you may want to look into the Medicare Savings Program (MSP). The program is funded through Medicaid, is administered through the Louisiana Department of Health and Hospitals, and it provides assistance to Medicare beneficiaries who meet certain income and asset guidelines. The program has three categories, depending on your financial situation.

Qualified Individuals (QIs) are eligible for assistance with costs of the Part B monthly premium. Individuals in this category have a monthly income of $1426 or less and their assets are no more than $7730. (Allowances are made for house, car and burial costs.)  Couples can have a monthly income of $1923 and their assets can be as high as $11,600.

Specified Low-Income Medicare Beneficiaries (SLMBs) are eligible for more assistance with their Part B monthly premium. The asset limits are the same, but the monthly income limits are lower. For individuals, the limit is $1269 and for couples, the limit is $1711.

Qualified Medicare Beneficiaries (QMBs) are eligible for Part A premium coverage (for those who haven’t worked long enough to qualify for the zero premium), Part B premium coverage, and coinsurance. The coinsurance is provided by issuing a Medicaid card, or in the case of someone who wishes to obtain a Medicare Advantage Plan (Part C), it provides a cost share benefit. People on this program often say they have both Medicare and Medicaid. Again, the asset limits are the same as for the other two programs. The monthly income limit for individuals is $1061 and for couples is $1430.

The easiest way to apply for these benefits, is to contact your nearest SHIIP counselor. For residents of Northwest Louisiana, call (800) 256-3003. The State SHIIP office (Louisiana Department of Insurance) can be reached at 800-259-5300. You can also call Medicaid at 888-342-6207. If you are approved for a Medicare Savings Program, you will also be eligible for the Low-Income Subsidy program, which helps people pay for their Part D (prescription plan) drug costs.

By:  Bridget Lyman, Client Care Coordinator, Gilsoul & Associates, LLC

Remote Meetings Available