New Medicare Savings Program
Posted August 25, 2017
WHAT ARE MEDICARE SAVINGS PROGRAMS?
Medicare offers insurance for expenses due to hospital care (Part A), other medical care (Parts B and C), and prescriptive drugs (Part D). Medicare Savings Programs (or “MSPs”) are offered by TennCare to help low-income people by paying some of Medicare’s out-of-pocket costs. Those costs include premiums, deductibles, coinsurance, and copayments. Four Medicare Savings Programs exist:
- Qualified Medicare Beneficiary (or “QMB”) helps with Part A and B premiums, deductibles, coinsurance, and copayments.
- Specified Low-Income Medicare Beneficiary (or “SLMB”) helps with Part B premiums only.
- Qualifying Individual (or “QI”) helps with Part B premiums only.
- Qualified Disabled and Working Individuals (or “QDWI”) helps people currently working with Part A premiums only.
HOW TO GET OR KEEP YOUR MSP BENEFITS IF YOU ALREADY RECEIVE MSP BENEFITS:
Please keep your information up-to-date with TennCare. You will need to fill out an annual redetermination packet that will be sent to you in the mail. When you receive the redetermination packet, please fill out the information, make a copy for yourself, and send it back as soon as possible.
IF YOU RECEIVE MEDICARE:
Please call the Tennessee Health Connection at 1-855-259-0701 and request an application. They will screen your information to determine if you qualify for MSP benefits.
IF YOU DO NOT RECEIVE MEDICARE:
Please call the Social Security Administration at 1-800-772-1213 to apply for Medicare benefits. If you qualify and begin receiving Medicare, then you should follow the steps above to apply for MSP benefits.
IF YOUR SOCIAL SECURITY CHECK HAS BEEN REDUCED:
Please call West Tennessee Legal Services (“WTLS”) to see if we can help. If your MSP benefits have ended, your Medicare Premiums will be deducted from your monthly check. We may be able to get your MSP benefits back.
WHO IS QUALIFIED?
You may qualify by meeting each of the following requirements.
Requirement 1 of 2:
Medicare Part A Eligibility
The first requirement is that you already receive (or are qualified for) Medicare Part A. Generally, you are eligi/ble for Medicare Part A if:
You are at least 65 years old and either a U.S. citizen or a permanent legal resident for five (5) consecutive years; or
You already receive retirement or disability benefits; or
You have either end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (Lou Gehrig’s disease or ALS).
Requirement 2 of 2:
Income and Resource Limits
The second requirement is that your income and available resources fall below certain limits. The limits are specific and change, but you generally may qualify if
You earn fewer than $1,400 per month individually (or are a married couple earning less than $1,850);
You have fewer than $7,400 in savings (or are a married couple with less than $11,100)
Also, QDWI is available if your monthly income is not greater than $4,105 (or $5,499 as a married couple).
Special Thanks to:
Acknowledgements & Disclaimer: This Fact Sheet was prepared by West Tennessee Legal Services (WTLS) and made possible by Serving Tennessee Seniors-administered by The Community Foundation of Middle Tennessee at the request of the Chancery Court. WTLS thanks the Tennessee Bar Association for its permission to use The Legal Handbook for Tennessee Seniors (2014 edition) as a primary information source. This publication is supported, in part, by funds provided by the Southwest Area Agency on Aging and Disability, the Tennessee Commission on Aging and Disability, and the U.S. Department of Health and Human Services. The content herein does not necessarily reflect the opinion or policy of the Southwest Area Agency on Aging and Disability or any agency of Tennessee or the U.S. government. Fact Sheets are for information only and not intended to replace legal advice. If you are in need of legal help, call WTLS at (800) 372-8346, or seek the help of a private attorney. (Revised 5/2017)