Do Low-Income Seniors Have to Pay for Medicare?

Medicare is a flexible health insurance policy, as it acknowledges that some have financial hardships that could keep them from having the same coverage as everyone else in their age group.

Determining low-income

In order for an individual to be designated as low-income, they must earn below a certain amount in order to receive extra government assistance. This income in particular is the Modified Adjusted Gross Income (MAGI), and the requirements for it are set by your state government.

Medicaid helps

Medicaid is primarily centered on providing financial assistance to those who struggle paying medical expenses. There’s no rule stopping you from having both Medicaid and Medicare together. If you meet your state’s MAGI requirement, then you’ll qualify for Medicaid and most of your medical expenses will be covered. It should also be noted that your state Medicaid program may go by a different name. For some, it’s called “Medi-Cal” and others simply call it “Medical Assistance”.

Medicaid and Medicare complement each other well – in some cases, Medicaid will cover what Medicare either doesn’t cover or only partially covers. These are costs like nursing home stays, hearing care, eye care, and dental care.

Medicare Savings Programs can eliminate certain costs entirely

Medicare Savings Programs are divided into the following types:

  • Qualified Medicare Beneficiary (QMB)
  • Specified Low-Income Medicare Beneficiary (SLMB)
  • Qualifying Individual (QI)
  • Qualifying Disabled and Working Individual (QDWI)

The QMB program helps you save by assisting with Medicare Part A and Part B payments. If you have this, healthcare providers are prohibited from billing you for Medicare-covered services, and in fact, if they do bill you, you should take action. The problem will be corrected as soon as you let your provider know that you are in the QMB program. Either that bill will be waived, or you will get a refund if you’ve already paid for what you’ve been wrongfully billed for.

The SLMB program strictly covers Medicare Part B premiums, and nothing else.

The QI program works similarly to the SLMB program. It only helps with Medicare Part B premiums. Also, getting enrolled is a matter of first-come, first-serve. It’s not based on who needs it the most.

Finally, the QDWI program strictly applies to those who are both employed and disabled, and this would only help pay Part A costs.

In summary

Low-income seniors should not have to panic at the thought of getting healthcare treatment. The government recognizes that each individual has his or her own financial circumstances to deal with, and thankfully, there are federal and state programs in place to help low-income seniors get the treatments they need with minimal out-of-pocket costs.

Need extra help?

Temmen Insurance is here to help you because you’re more than your financial situation. When you call us, we will discuss your situation and help you find a plan that leaves you with as few out-of-pocket expenses as possible. Call us today at 417-633-7200.

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