Medicaid Medicare Your Coverage Options

Five programs that lower your costs if you have Medicare

Written by Diane Archer

Even with Medicare, many people struggle to afford premiums, deductibles and other out-of-pockets health care costs. There are five federal programs that lower your costs for care even if you do not qualify for Medicaid:

  1. Veterans’ Administration: If you are a vet, the Veterans’ Administration (VA) offers low-cost services and prescription drugs directly. And, you can have VA coverage as well as Medicare.
  2. Medicare Savings Programs: Depending on your income, these programs help pay for Medicare premiums and coinsurance, even if you don’t qualify for Medicaid. There are three programs, Qualified Medicare Beneficiary (QMB), Specified-Low Income Medicare Beneficiary (SLMB) and Qualified Individual (QI). Income and asset limits, and how they are counted, vary somewhat by state. You should apply through your local Medicaid office.
  3. Extra Help with Medicare Part D prescription drug coverage: You may qualify for Extra Help, which pays for some or all of the cost of your drug coverage, so long as your income is under $1471 (individual) or $1991 (couple) and your assets are below $13,070 (individual) or $26,120 (couple). You get this automatically if you have Medicaid or a Medicare Savings Program. Some states have State Pharmaceutical Assistance Programs that provide even more assistance.
  4. Federally Qualified Health Centers (FQHCs) and other programs run by the Human Resources and Services Administration: FQHCs are located across the country and serve underserved populations and areas on a sliding-feed scale. They might waive the Medicare deductible and coinsurance, depending upon your income.
  5. Hill-Burton programs offer free or reduced care at Hill-Burton facilities in 38 states. Hill-Burton does not cover services fully covered by Medicare or Medicaid. Eligibility depends on your family size and income.

Keep in mind that you may be eligible for Medicaid based on your income after paying for some health care costs. For information on Medicaid, click here. To learn more about these programs, free local resources, and other programs that could help, contact your State Health Insurance Program. To contact your state Medicaid office, click here.

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2 Comments

  • Because of the state insurance rules and rnoalutiges, New York has some of the highest premiums in the country and there is very little difference between companies. A difference in premium will mean a big difference in coverage. You’ll need to contact a local agent that works with all of the major companies. The agent can work with you and can explain what you get with the different policies.References : Independent Agent

  • I’ve checked in my state, Georgia, which hasn’t expanded Medicaid, and I don’t qualify for any assistance even though my income is below 15K a year. Some years it’s below 13K.
    This is because, I don’t own my house, I rent, and I have some money in a saving, checking, and a Roth IRA account. It’s not enough to help me long term, but enough to disqualify me from any assistance as you can’t have assets over about $7,500, at least in my state.

    Seems ridiculous to me as if I had some fancy cars, owned my house, or more than one house, with investment property, or had other assets, not counted, then I would qualify.
    It seems that home owners or people that own their own business or have assets outside of common savings, checking, or IRA, get a pass on restrictions on help for medical insurance.

    I would have to spend just about all of my savings to qualify for assistance and that would be plain stupid at this point.

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