The Medicare Savings Programs are federal and state funded assistance programs that help pay for some Medicare expenses for those that do not qualify for Medicaid (MO HealthNet) benefits. They require that an individual have:
- Incomes below 135% of the federal poverty level, and
- Resources below $6600 for a single person or below $9910 for a couple, and
- Work only to help cover certain Medicare related expenses.
If you qualify for any of the Medicare Savings Programs, you automatically qualify for the Prescription Drug Extra Help program. Medicare will pay the premiums for a basic prescription drug plan, pay for most covered medications cost except for small co-pays. The beneficiary will not have the gap in coverage and if they reach the out of pocket maximum Medicare will pay 100% of their covered medication costs.
The chart below details the three available programs and the assistance that they offer:
|
What It's Called
|
Income Level
(must also meet resource requirements)
|
What It Pays For
|
|
QMB
Qualified Medicare Beneficiary
|
$903 per month or $1,215 for married couples in 2009
(Federal poverty level or lower)
|
- Medicare Part A monthly premium (when applicable)
- Medicare Part B monthly premium and annual deductibles
- Co-insurance and deductibles for both Medicare Part A and Part B
- Cost-sharing for Medicare Advantage
- Pays premiums for Medicare Part D Basic Plans, reduces copays, eliminates deductibles and coverage gap.
|
|
SLMB
Specified Low-Income Medicare Beneficiary
|
$1,083 or $1,457 for married couples in 2009
(120% of the Federal poverty level or lower)
|
- Medicare Part B monthly premium
- Pays premiums for Medicare Part D Basic Plans, reduces copays, eliminates deductibles and coverage gap.
|
|
QI-1 (SLMB-2)
Qualified Individual-1
|
$1,219 or $1,640 for married couples in 2009
(135% of the Federal poverty level or lower)
|
- Medicare Part B monthly premium. Federal funding is subject to availability.
- Pays premiums for Medicare Part D Basic Plans, reduces copays, eliminates deductibles and coverage gap.
|
To apply for any of the Medicare Savings Programs a MO HealthNet (Medicaid) application must be completed and submitted to your local Family Support Division Office. Get the application here. If you have questions about your benefits, contact your local Family Support Division office. Click here to find your county's Family Support Division office.
Return to Programs to Help You Pay