Help available for Medicare bills

Just when we think we’ve reached every possible senior with low income and have signed them all up for what we call the “buy-in program,” we get a notice from the Boston regional office of the federal Centers for Medicare and Medicaid Services. That agency believes there could be 2,500 people in Penobscot County – 800 people in Bangor – who still qualify but are not participating.

Can this be true? Are you one of these people? If so, Stacie Sparkman, state health insurance assistance program technical counselor, wants to meet you.

“You may hear the term ‘LIS’ or ‘Low Income Subsidy’ thrown around,” Sparkman said. “This is the program administered through the Social Security Administration that provides assistance with Part D prescription coverage for those individuals with limited income and assets. Here in Maine, we don’t use this program [because] our Medicare savings plan gives out much better benefits.”

So just what is the MSP-Medicare Savings Plan or Buy-In?

“This plan also gives assistance to people with limited income,” Sparkman said. “In Maine there is no asset test, so what you have in the bank – an IRA, a CD, stocks and bonds hidden under the mattress, doesn’t count. Your house and car do not count either.”

There are three levels of MSP and each one pays for the monthly Part B premium, which is currently $96.40.

If someone qualifies for the MSP, it automatically makes him or her eligible for the federal low-income subsidy, which helps pay for Part D.

“The person does not have to pay the monthly premium for most Part D plans, and there is no cost at the pharmacy for generic drugs and $2.80 co-pay for brand name prescriptions, as long as – and this is important – the drug is on the Part D plan’s formulary,” or approved list, Sparkman said.

One section of the MSP called Qualified Medicare Beneficiary also helps pay some medical costs associated with Medicare Parts A and B.

Now for the guidelines. And as always, if you are unsure if you qualify, call us. We can help you and you may be pleasantly surprised.

“A person’s or a couple’s income, and only the income, determines what level of MSP they qualify for,” Sparkman said. “I never like to give out the actual figures for approval, as the Department of Health and Human Services determines eligibility and there are exceptions to the rules, but the ball park figure for an individual is $1,600 per month and a married couple is $2,200 per month. We at EAAA want to see folks who are in that range, even above … to see if they might qualify. I never want anyone to rule themselves out of a program if they think that they even come close to those numbers.”

If there is a chance that you are eligible, give us a call at 941-2865. We want to save you all the money we can. Sparkman outlines what you can expect from a meeting with one of our staff.

“An appointment with a staff person at EAAA would take around half an hour,” she said. “We ask people to bring their red, white and blue Medicare card, a list of all current medications including dose and frequency, as well as their income information. If a person’s or couple’s only income is Social Security, DHHS verifies that with Social Security, but if there is a pension of any sort, we need proof of that.

“Sometimes the easiest way to provide that is with a monthly bank statement,” she said, “since most people have [their checks placed in the bank by] direct deposit. We will check it all out and maybe get you signed up if you qualify. It is that simple.”

Saving money was never so easy.

Carol Higgins Taylor is director of communications at Eastern Area Agency on Aging. Email Higgins Taylor at chtaylor@eaaa.org. For information on EAAA, call 941-2865, toll-free (800) 432-7812, e-mail info@eaaa.org or log on EAAA.org. TTY 992-0150.