Help with Medicare and Prescription Drug Costs: The Medicare Savings Program

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Is there any help for people to pay their Medicare premiums, co-payments or deductibles or to pay for prescription drugs?

Yes.  For people with low income, MaineCare can help pay some or all of the Medicare premiums, co-insurance and deductibles, including paying for most of the Medicare Part D prescription drug costs. This MaineCare program is called the Medicare Savings program.  It is also known as the Medicare Buy-in program or QMB, SLMB or QI. 

Who can get help from the Medicare Savings Program?

  • If you are single and your income is less than $1792 a month you may get help.
  • If you are married and your income is less than $2424 a month then you may get help.
  • If only one person in a couple wants the help, then the income limit may be as high as $2791 per month.
  • If you have earned income, the income limits may be higher.
  • Most assets do Not Count.  However, liquid assets greater than $58,000 for an individual and $87,000 for a couple will count.  Liquid assets are those that are easy to convert to cash, such as checking/savings accounts, most retirement accounts, some annuities, etc.

Can the Medicare Savings Program help me with prescription drug costs?

Yes. If you get into the Medicare Savings Program, then you will not have any Medicare Part D:

  • premiums
  • deductibles
  • "donut hole"

Your co-payments will be very low.  You can change your Part D plan whenever you want.

How do I apply for the Medicare Savings Program?

You apply at the Maine Department of Health and Human Services (DHHS).

Do I have to reapply each year?

You will get a form in the mail before the end of each twelve month period. Be sure to fill it out and send it in right away.

Will my estate have to pay MaineCare back for what it pays for me in the Medicare Savings Program?

No. If you are only on the Medicare Savings Program, the State will not go after your estate.

However, if you get regular MaineCare and you are age 55 or older, DHHS may make a claim on your estate after you die, to recover the money that MaineCare has paid for your care.

If I have a Medigap (Medicare Supplement) policy, should I keep it if I get onto this program?

It depends.  If you are a QMB, then probably not.  You may find – depending on the coverage you have chosen – that you no longer need that policy.  However, if you only have SLMB/QI, then only your Medicare Part B Premiums are paid, but not your deductibles and co-insurance.

You can suspend your Medigap policy for up to 24 months.  Call Legal Services for the Elderly at 1-800-750-5353 before you suspend or drop your policy to be sure it’s the best thing to do.

Updated: August 2015

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