What are Medicaid and Medicare Savings Programs and how do I apply?

If you live in New York and have limited income, you might get help with your healthcare costs through a program called Medicare Savings Program (MSP) or Medicaid. Here's a summary of these programs:

1. Qualifying Individual (QI):

   • Pays for your Part B premium.
   • Can provide retroactive reimbursement for up to three months of Part B premiums (within the same year as your MSP effective date).
   • You can't have both QI and Medicaid.

2. Qualified Medicare Beneficiary (QMB):

   • Covers Medicare premiums.
   • Providers can't charge you for Medicare cost-sharing (like deductibles, coinsurance, and copayments). You won't get billed for Medicare-covered services.
   • You can have both QMB and Medicaid.

3. Medicaid:

   • Offers health coverage for people with limited income and assets.
   • For services covered by both Medicare and Medicaid, Medicare pays first, and Medicaid may help with Medicare cost-sharing (such as coinsurance and copayments).
   • Medicaid may cover services that Medicare doesn't, like dental and vision.
   • You might qualify for QMB, which covers your Part B premium.
   • To apply for Medicaid, contact your local Medicaid office.
   • If your income is above the guidelines, you could still be eligible for Medicaid through spend-down. Contact your local Medicaid office for more information.

If you meet the income limits and live in New York, you can apply for an MSP through the Medicare Rights Center at 800-333-4114 or your local Medicaid office (Department of Social Services). When applying, you'll need to submit a signed application along with copies of various documents like your Social Security card, Medicare card, proof of identity, address, and income.

If you're denied MSP benefits and believe you qualify, you have the right to request a fair hearing to challenge the decision.

By enrolling in an MSP, you'll also automatically receive Extra Help, a federal program that assists with Medicare prescription drug (Part D) plan costs.

If you're eligible, these programs can help ease the financial burden of healthcare expenses. Reach out for assistance and apply to get the support you need.