Medicare is complicated, and there are so many different ways to organize cost and coverage for your personal needs. However, if you can’t find something affordable that works for you with the more common programs available, there may still be help.
Can I get Medicaid if I am enrolled in Medicare?
Yes, if you qualify for both Medicare and Medicaid you have what is known as “dual eligibility.” When you have dual eligibility you can access services associated with Medicare at a cheaper rate, and may have expanded access to other services available under Medicaid such as vision, hearing and dental.
Each state has its own Medicaid program, so check with your state’s program to see if you qualify. In some cases there is a “spend down” program where you can subtract the cost of your medical expenses to your income to be able to qualify.
How can I get help with prescription drug costs?
Some people may qualify for lower rates on prescription drugs with Medicare Part D, through the Extra Help program. Extra Help calculates lower rates to your drug copays and coinsurance costs based on your income and where you live.
In 2020, you qualify if you have up to $19,140 in yearly income and $14,610 in resources as an individual or $25,860 or $29,160 in a married couple. Resources are defined as money in a bank account, stocks or bonds. If you don’t qualify for this national program, you may qualify for a state program. If you qualify for Medicaid, you automatically qualify for Extra Help as well.
How can I get help for my Medicare Part A and B expenses?
Some states have a Medicare Savings Program, which covers the costs associated with Original Medicare. You may be eligible for a Qualified Medicare Beneficiary program, which means your monthly income is less than $1,084 (2020) as an individual or $1,457 (2020) as a married couple. If you qualify for this help you will also qualify for the Extra Help program for prescription drug costs.
Are there any special plans designed for my chronic condition?
In some cases, yes. There are Medicare plans tailored to the costs associated with specific chronic conditions such as diabetes or heart disease. These are known as Special Needs Plans, and their availability varies by location.
These can help save money because they will generally bundle the costs commonly associated with a certain condition so that you end up paying less overall if you utilize this program. The plan may also have specialized networks of providers for this condition.
What is PACE?
PACE stands for Programs of All-Inclusive Care for the Elderly. These are programs designed to keep costs down by helping elderly people meet their needs within the community instead of only through larger state-wide or national programs.
PACE offers help at home, at community centers and at local PACE offices. This can cut costs for anyone struggling to pay for medical services like at-home nursing care.
Are there any other programs that can help me save money?
Yes, there are a few other options for those who qualify. A few of these include special programs for people living in US territories like Guam or Puerto Rico, supplemental social security income for seniors with a low monthly income and the Insure Kids program which offers low-cost and free health care to children.
There may be additional local resources available as well depending on where you live, but these are some of the most common ways to get some help with health care costs for those using Medicare.