Medicaid
Medicaid
is a joint federal and state program that helps pay medical costs for some
people with limited incomes and resources. Medicaid also offers benefits not
normally covered by Medicare, like help with personal care and rides to doctor
appointments. If you qualify for Medicaid in your state, you automatically
qualify to get
Extra Help
paying
for Medicare prescription drug coverage.
How to Apply for Medicaid
Medicaid
is run by the states, so rules about eligibility and how to apply are different
for each state. Call your state to see if you qualify for your state's Medicaid
program.
Use the Helpful Contacts Directory
to
find the phone number.
Medicare Savings Programs
Medicare Savings Programs can help pay all or part of your Part A and/or Part B
premiums if you meet certain income and resource limits. There are four types
Medicare Savings Programs:
-
Qualified Medicare Beneficiary (QMB) Program
You must be eligible for Part A to qualify, even if
you’re not enrolled.
-
Specified Low-Income Medicare Beneficiary (SLMB) Program
You must be eligible for Part A to qualify, even if
you’re not enrolled. If you have income from working, you may qualify for SLMB
benefits even if your income is higher than the limits in the chart below.
-
Qualified Individual (QI) Program
You must be eligible for Part A to qualify, and you
must apply every year for QI benefits. QI applications are granted on a
first-come, first-served basis, with priority given to people who got QI
benefits the previous year. QI benefits aren't available to people who
qualify for Medicaid.
-
Qualified Disabled and Working Individuals (QDWI) Program
The QDWI
program helps pay the Part A premium. You may qualify if you:
- Are a working disabled person under age 65
- Lost your premium-free Medicare Part A when you went back to work
- Aren't getting medical assistance from your state
- Meet the income and resource limits required by your state
Income and resource limits for Medicare Savings Programs are below.
If you qualify for a Medicare Savings Program in your state, you automatically
qualify to get
Extra Help
paying for Medicare prescription drug coverage.
NOTE: The income and resource limits
below will be updated with the 2010 dollar amounts when the official numbers are released.
| Qualified Medicare Beneficiary (QMB) |
$923 |
$1,235 |
- Part A premiums
- Part B premiums
- Deductibles, coinsurance, and copayments
|
| Specified Low-Income Medicare Beneficiary (SLMB) |
$1,103 |
$1,477 |
Part B premiums only |
| Qualified Individual (QI) |
$1,239 |
$1,660 |
Part B premiums only |
| Qualified Disabled and Working Individuals (QDWI) |
$3,695 |
$4,942 |
Part A premiums only |
| *Limits are slightly higher in Alaska and Hawaii |
| Medicare Savings Program 2009
Resource Limits |
| Resource limits for all Medicare Savings Programs are
$4,000 for a single person and $6,000 for a married couple. |
How to Apply for Medicare Savings Programs
Call your State Medicaid Program to see if you
qualify for a Medicare Savings Program in your state
Extra Help
If you meet certain income and resource limits, you may qualify for Extra Help
from Medicare to pay the costs of Medicare prescription drug coverage. People
who qualify for the most Extra Help pay nothing for their Medicare drug plan
premium and deductible, and only $2.50 generic/$6.30 brand-name for their
covered drugs. Other people pay only a portion of their Medicare drug plan
premiums and deductibles based on their income level.
You may qualify if you have up to $1,354 in monthly income ($1,821 for a married
couple) and up to $12,510 in resources ($25,010 for a married couple).
NOTE: These amounts will be updated when the official 2010 numbers are released.
How to Apply for Extra Help
If you qualify for Medicaid, belong to a Medicare
Savings Program, or get Supplemental Security Income (SSI) benefits, you
automatically get Extra Help with Medicare drug costs. Otherwise, you can
apply online at Social Security
, or call Social Security at 1-800-772-1213 to apply
by phone or get a paper application. TTY users should call 1-800-325-0778.
State Pharmaceutical Assistance Programs (SPAPs)
Some states have State Pharmaceutical Assistance Programs (SPAPs) that help people pay prescription drug costs.
How to Apply for SPAPs
Each
SPAP has different rules about eligibility, how to apply, and how it works with
Medicare prescription drug coverage. For more information, call the SPAP in your
state. Find the phone number on the
State Pharmaceutical Assistance Program Site.
Pharmaceutical Assistance Programs (PAPs)
Some drug companies have Pharmaceutical Assistance Programs (PAPs) that help people pay for the drugs they make.
How to Apply for PAPs
You can
find out more about PAPs and see if any programs are available for the drugs you
are taking at
Medicare Pharmaceutical Assistance Program
Programs of All-inclusive Care for the Elderly (PACE)
PACE is a Medicare and Medicaid program that helps people meet their health care
needs in the community instead of going to a nursing home. PACE covers
prescription drugs, doctor visits, transportation, home care, check-ups,
hospital visits, and even nursing home stays whenever necessary.
To qualify for PACE, you must:
- Be 55 or older
- Live in the service area of a PACE organization
- Need a nursing home-level of care (as certified by your state)
- Able to live safely in the community with help from PACE
For more information about PACE, see
"Quick Facts about Programs of All inclusive Care for the Elderly."
How to Apply for PACE
Call your
State Medical Assistance (Medicaid) office
to find out if you qualify for a PACE program near
you.
Other Ways to Lower Your Prescription Drug Costs
- Look into generic drugs
- Ask your doctor about less expensive brand-name drugs
- Consider using a mail-order pharmacies
- Compare Medicare drug plans to find a plan with lower costs