Medicare was designed to provide comprehensive and low cost health insurance to senior citizens.  However, it can still be a financial burden to many.  Fortunately, there are many ways to afford Medicare on a fixed income.

 

Medicaid and DSNPs

If you are living on a fixed income, (possibly social security alone) and your assets are limited you may qualify for Medicaid in addition to Medicare.  You may also qualify for Medicaid based on disability or illness.  Medicaid eligibility is determined by the federal poverty guide, your household size and your state!  Some states have more lenient criteria than others.  So it is very important that you contact your state’s Medicaid office to determine eligibility.  We strongly encourage you to contact Medicaid if you think you may be eligible.

Medicaid can work in conjunction with Medicare to help you pay for your Medicare expenses.  If you are eligible for both, you may want to look into a DSNP (Dual Eligibility Special Needs Plan).  DSNPs are a great option!  DSNPs are a type of Medicare Advantage Plan (aka Medicare Part C).  They will afford you the fill benefits of Medicare Part A, your hospital insurance and Medicare Part B, your outpatient insurance as well as the full benefits of Medicaid.  Additionally, all DSNPs encapsulate prescription drug coverage.  

DSNPs are highly competitive plans, which is great news for those on a fixed income.  Because DSNPs are offered by private carriers, they compete for your business offering excellent fringe benefits such as:

Dental

Vision

Hearing

Transportation to Appointments

Even Meal Service!

 

Medicare Savings Programs

Another option for those living on a fixed income is Medicare Savings Programs. There are four different programs.  Each program has different criteria and different benefits.  Some of these work in conjunction with DSNPs. So you may actually be able to take advantage of multiple programs.

QMB: Qualified Medicare Beneficiary

SLMB: Special Low Income Medicare Beneficiary 

QI: Qualified Individual

QDWI: Qualified Disabled Working Individual 

Although the programs are all slightly different, they basically help you to pay for your Medicare Part A Premium, your Medicare Part B premium and your prescription drug costs.  Some of these programs are first come, first serve so if you’re interested, do not let the grass grow under your feet!

 

Prescription Drug Coverage

Most of the Medicare Savings Programs will actually automatically enroll you in the Extra Help programs.  If you are living on a fixed income, Extra Help can you pay for Medicare Part D, your prescription drug coverage.  

The extra help program is dependent upon your income and resources. It will help you pay for your Medicare Part D monthly premium and provide assistance with your deductible. Additionally, you cannot be charged more than $3.70 for a generic and $9.20 for a brand named covered drug (in 2021).

You can also look into State Pharmaceutical Assistance Programs and Pharmaceutical Assistance Programs.  State Pharmaceutical Assistance Programs can offer assistance in every area not covered by Medicare Part D.  However, they are not offered in every state. In fact, most states do not offer these types of programs.  Check out Medicare.gov to see if any type of program is offered in your state.

Pharmaceutical Assistance Programs may offer limited supplies of free prescriptions for those living on a fixed income, but eligibility varies.  

Additionally, the afford Medicare on a fixed income, do your research!  Make sure to enroll on time and enlist a licensed broker to avoid common (and costly) Medicare mistakes.    If you’d like our assistance, you can reach us at iHealthBrokers at 888-918-0518 or schedule a call today.