Your Medicare Community - MedicareFAQ

Medicaid & Medicare Savings Programs

April 26, 2021 Lindsay
Your Medicare Community - MedicareFAQ
Medicaid & Medicare Savings Programs
Show Notes Transcript

If you're unsure what the differences are between Medicare and Medicaid, don't go anywhere. In today's video, we're going to explain the difference between the two, as well as additional Medicare Savings Programs you could be eligible for.

Medicare is a federally funded program for those who are over 65 as well as those who are under 65 with a disability. With Medicare, the benefits are the same across all 50 states, and your income is not an eligibility factor.  With Medicaid, It's funded both on the federal level and the state level. You're eligible at any age and benefits and criteria do vary from state to state. With Medicaid, you must meet the low-income criteria within your state to become eligible.

If you meet the eligibility criteria for both Medicare and Medicaid, that means your dual-eligible. Those who are dual-eligible can qualify for a Medicare Savings Program. These programs help pay for your Medicare cost including deductibles, co-pays, and coinsurance. In addition, all of those who are eligible for Medicare Savings Program are also eligible for a program called Extra Help.

Extra Help provides assistance with your prescription drug cost under Part D. Also, if you delayed enrolling into Part D and incurred a late enrollment penalty because of it, that penalty will be waived if you're eligible for Extra Help. To qualify for Medicare Savings Program you must be already enrolled or at least eligible for Part A and your income and resources must meet the federal and state limits set for the program. 

There are four different types of Medicare Savings Programs. The first type of Medicare Savings Program we're going to go over is called the Qualified Medicare Beneficiary Program, or QMB. With the Qualified Medicare Beneficiary Program, you will have coverage for the Part B premium. If by chance you were not eligible for premium-free Part A then the Qualified Medicare Beneficiary Program will also cover your Part A premium. Medicare will be your primary coverage and your QMB will be your secondary. This means you won't need any Medigap plan since your QMB will cover your premiums, co-pays, and deductibles. The Qualified Medicare Beneficiary Program is the highest level of Medicare Savings Program you can get. 

The second type of Medicare Savings Program available is the Specified Low-Income Medicare Beneficiary or SLMB. The Specified Low-Income Medicare Beneficiary Program will pay for your Medicare Part B premium. 

The next type of Medicare Savings Program is Qualified Individual or QI. The Qualifying Individual Program will also pay for your Medicare Part B premium. The only difference is that you must apply for this program each year. It's on a first come first serve basis. 

The fourth and final type of Medicare Savings Program is the Qualified Disabled and Working Individual, or QDWI. If you're under 65, disabled, and working and you can qualify for the QDWI. This program will pay for the premium for your Part A. The most common question we get about the QDWI program is if you must be working? And the answer is yes, you must be under 65 disabled and still working to qualify.

Keep in mind, each state may have a different name for these types of Medicare Savings Program. So don't be confused if your local Medicaid office refers to them with a different name. You can apply for any of the Medicare Savings Programs at any time of the year at your local Medicaid office. 

The list of what you need to apply can vary by state, but in general, you'll need to provide:
- Proof of residence
- Proof of age
- Other forms of insurance, like Medicare
- Checking and savings accounts
- Retirement accounts
- Stocks and bonds
- Mutual funds

Resources that aren't counted would include:
- Your primary residence
- Household items
- Any furniture
- One car

If you're unsure what the differences are between Medicare and Medicaid, don't go anywhere. In today's video, we're going to explain the difference between the two as well as additional Medicare Savings Programs you could be eligible for. Hi Medicare Community. My name is Lindsay Engle. I'm the Medicare expert for Elite Insurance Partners and MedicareFAQ.com. Medicare is a federally funded program for those who are over 65 as well as those who are under 65 with a disability. With Medicare, the benefits are the same across all 50 states, and your income is not an eligibility factor. With Medicaid, It's funded both on the federal level and the state level. You're eligible at any age and benefits and criteria do vary from state to state. With Medicaid, you must meet the low-income criteria within your state to become eligible. If you meet the eligibility criteria for both Medicare and Medicaid, that means your dual-eligible. Those who are dual-eligible can qualify for a Medicare Savings Program. These programs help pay for your Medicare cost including deductibles, co-pays, and coinsurance. In addition, all of those who are eligible for Medicare Savings Program are also eligible for a program called Extra Help. Extra Help provides assistance with your prescription drug cost under Part D. Also, if you delayed enrolling into Part D and incurred a late enrollment penalty because of it, that penalty will be waived if you're eligible for Extra Help. To qualify for Medicare Savings Program you must be already enrolled or at least eligible for Part A and your income and resources must meet the federal and state limits set for the program. There are four different types of Medicare Savings Programs. The first type of Medicare Savings Program we're going to go over is called the Qualified Medicare Beneficiary Program, or QMB. With the Qualified Medicare Beneficiary Program you will have coverage for the Part B premium. If by chance you were not eligible for premium-free Part A than the Qualified Medicare Beneficiary Program will also cover your Part A premium. Medicare will be your primary coverage and your QMB will be your secondary. This means you won't need any Medigap plan since your QMB will cover your premiums, co-pays, and deductibles. The Qualified Medicare Beneficiary Program is the highest level of Medicare Savings Program you can get. The second type of Medicare Savings programs available is the Specified Low-Income Medicare Beneficiary or SLMB. The Specified Low-Income Medicare Beneficiary Program will pay for your Medicare Part B premium. The next type of Medicare Savings Program is Qualified Individual, or QI. The Qualifying Individual Program will also pay for your Medicare Part B premium. The only difference is that you must apply for this program each year. It's on a first come first serve basis. The fourth and final type of Medicare Savings Program is the Qualified Disabled and Working Individual, or QDWI. If you're under 65, disabled, and working and you can qualify for the QDWI. This program will pay for the premium for your Part A. The most common question we get about the QDWI program is if you must be working? And the answer is yes, you must be under 65 disabled and still working to qualify. Keep in mind, each state may have a different name for these types of Medicare Savings Program. So don't be confused if your local Medicaid office refers to them with a different name. You can apply for any of the Medicare Savings Programs at any time of the year at your local Medicaid office. The list of what you need to apply can vary by state, but in general, you'll need to provide proof of residence, proof of age, other forms of insurance, like Medicare, checking and savings accounts, retirement accounts, stocks and bonds, and mutual funds. Resources that aren't counted would include your primary residence, household items, any furniture, and one car. Hopefully, now you have a good understanding of the differences between Medicare and Medicaid, and the different types of Medicare Savings Programs those who are dual-eligible can qualify for. If you found this video helpful, make sure to subscribe to our YouTube channel. Turn notifications on, so you're notified each time we upload a new video. We also have a great Medicare community on Facebook. Well make sure to include a link in the description below so you can join. Until next time. Bye.