Simply Explained: Medicare Savings Programs (MSPs)
When you sell Medicare, your clients are going to want to know what you’re selling them, why you’re selling it, and how much it’s going to cost them. Some of your clients will be eligible for Medicare Savings Programs.
MSPs will help clients pay for their premiums. In some cases, they will also help to pay for Original Medicare (Parts A and B) deductibles, copayments, and coinsurance. Use of an MSP will also create automatic eligibility for Extra Help, giving your client access to help with their Part D, or prescription drug plan. Funding for MSPs comes from state Medicaid programs.
If your client is eligible for MSPs, they may be more likely to buy from you.
The four major MSPs are reserved for employed Medicare clients. Eligibility is based on income and resource level.
Resources include:
- Money in a checking or savings account
- Stocks and bonds
Resources do not include:
- House or car
- Burial plots
- Furniture or other personal property
The following will make your client eligible for MSPs:
- QMB (Qualified Medicare Beneficiary) Program – Pays for Part A&B premiums, deductibles, coinsurance, and copayments.
- Single monthly income of less than $1,010
- Married monthly income of less than $1,355
- Single resources of less than $7,280
- Married resources of less than $10,930
- SLMB (Specified Low-Income Medicare Beneficiary) Program – Pays for Part B premiums.
- Single monthly income of less than $1,208
- Married monthly income of less than $1,622
- Single resources of less than $7,280
- Married resources of less than $10,930
- QI (Qualifying Individual) Program – Pays for Part B premiums. Must apply every year; first-come, first-serve with priority to renewals. Cannot have QI if you qualify for Medicaid.
- Single income of less than $1,357
- Married income of less than $1,823
- Single resources of less than $7,280
- Married resources of less than $10,930
- QDWI (Qualified Disabled and Working Individuals) Program – Helps pay for Part A premiums
- Working disabled person under 65
- Lost premium-free Part A eligibility after returning to work
- Do not receive state medical assistance
- Meet state-based income and resource limits
- Single income limit of a little over $4,000
- Married income limit of about $5,500
- Single resource limit of about $4,000
- Married resource limit of about $6,000
Make sure you’re asking the right questions to determine if your clients are eligible for an MSP. It could determine their ability to buy from you!
