Medicare Savings Plans, also known as a Medicare Savings Programs (MSP), are state-based programs that help eligible individuals with limited income and resources pay for their Medicare costs. In Minnesota, as in other states, MSPs are administered by the Department of Human Services (DHS). MSPs aim to alleviate the financial burden on low-income individuals by helping them cover expenses such as premiums, deductibles, co-insurance, and co-payments. They help ensure that more people have access to necessary health care services. MSPs are not the same as Medical Assistance (MA), but people who qualify for MSPs may also qualify for MA and vice versa. In Minnesota, there is a system called "Medicare Savings Program Integrated Eligibility," or MPIE, that allows for seamless coordination between MA and MSPs. When you apply for an MSP, the state will automatically determine your eligibility for both programs. This integrated approach simplifies the application process. Also, If you qualify for both Medicare and Medical Assistance you are considered "dually eligible" and can access the benefits of both programs.
However, you may qualify for MSPs even if you are not MA eligible. For the following available MSPs, you must fall below certain pre-established thresholds related to your monthly income and assets, and meet other eligibility criteria. You must also be enrolled in Medicare Part A (hospital coverage) and Medicare Part B (medical coverage). Note; these guidelines will be effective starting July 1, 2024.
Qualified Medicare Beneficiary (QMB).
The QMB program helps with Medicare Part A and Part B premiums, deductibles, coinsurance, and copayments. To qualify for QMB in Minnesota, an individual must have a monthly income below a certain limit and meet the asset limits set by the state. Starting July 1, 2024 and through June 30, 2025, the individual income limit for individuals is $1,275.00 and for couples, $1,724.00. Asset limits are $10,000 and $18,000 respectively.
Specified Low-Income Medicare Beneficiary (SLMB).
The SLMB program assists with Medicare Part B premiums. Individuals eligible for SLMB must have a monthly income slightly higher than the QMB limits and meet the asset requirements. Starting July 1, 2024 and through June 30, 2025, the individual income limit for individuals is $1,526.00 and for couples, $2,064.00. Asset limits are $10,000 and $18,000 respectively.
Qualifying Individual (QI).
The QI program also helps pay for Medicare Part B premiums. However, the funding for this program is limited, and enrollment is on a first-come, first-served basis. To be eligible for QI, individuals must meet monthly income and asset limits set by the state. Starting July 1, 2024 and through June 30, 2025, the individual income limit for individuals is $1,715.00 and for couples, $2,321.00. Asset limits are $10,000 and $18,000 respectively.
For Medicare beneficiaries under age 65 who are eligible due to disability, there is another MSP, the Qualified Disabled and Working Individuals (QDWI). It assists certain disabled individuals who have lost their premium-free Part A coverage due to returning to work. It helps pay for the Part A premium. Eligibility is based on income and asset limits. You must either be enrolled or eligible to enroll in Part A to apply for QDWI. Starting July 1, 2024 and through June 30, 2025, the individual income limit for individuals is $2,530.00 and for couples, $3,427.00. Asset limits are $4,000 and $6,000 respectively.
MSPs exist to enhance healthcare affordability and accessibility, promoting better health care outcomes for those who may otherwise struggle to meet their health care needs. To apply for MSPs in Minnesota, individuals can complete the Minnesota Health Care Programs Application for Certain Populations and return it to their local county's (or tribe's) human services office. It's important to note that eligibility criteria, income limits, and asset limits may change. Your local resource can help provide the most up-to-date information regarding MSPs.
On a final note, if you are eligible for both MA and an MSP, you might want to consider enrolling in a Special Needs Plan (a type of Medicare Advantage Plan) that has been designed specifically for Medicare beneficiaries who are dually eligible. These plans, called DSNPs, are offered by private insurance companies and can provide additional benefits beyond what Original Medicare offers. There are also low-premium Medicare Advantage plans available that might be helpful in expanding benefits for those who are not eligible for MA. And a federal program called Extra Help can significantly lower prescription drug costs and offer additional related benefits for even more Medicare beneficiaries, since they have higher income thresholds than other cost-saving opportunities.
Understanding all of these programs and how they work together can be overwhelming. You will benefit from contacting a licensed insurance agent who specializes in navigating Medicare options in order to ensure that you are maximizing your coverage at the lowest possible cost. Best of all, these enrollment assistance services are available at no cost to you! Click here to learn more.