Medicaid is a joint federal and state program.
Medicaid may help you pay medical costs if you have limited income and resources and meet other requirements. Some people are “dual eligibles,” which means they qualify for both Medicare and Medicaid.
If you have Medicare and full Medicaid coverage, most of your health care costs are covered. Medicare covers your Part D prescription drugs. Medicaid may cover some drugs plus other care that Medicare doesn’t cover.
People with Medicaid may get coverage for services that Medicare may not cover or only partially cover, like nursing home care, personal care, as well as home and community-based services.
Extra Help is a Medicare program to help people with limited income and resources pay Medicare prescription drug costs.
You will automatically qualify for Extra Help if you have Medicare and full Medicaid coverage, the state helps to pay for your Part B premiums through a Medicare Savings Program, or you get Supplemental Security Income benefits.
If you qualify, it will help you pay for your Medicare drug plan’s monthly premium, yearly deductible, coinsurance, and copayments. You will have no coverage gap or late enrollment penalty, and you can switch plans at any time.
Extra Help is not available in Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa.
Medicare Savings Programs (MSP) are available for those (with Medicare Part A) who have limited income and resources.
To qualify for assistance you must be:
- Single person with a monthly income of less than $1,333 and resources less than $7,160 (2015)
- Married and living together with a monthly income of less than $1,790 and resources less than $10,750 (2015)
Resources include money in a checking or savings account, stocks, bonds, mutual funds, and Individual Retirement Accounts (IRAs). Resources do not include your home, car, burial plot, burial expenses up to your state’s limit, furniture, or other household items.
There are 4 types of MSP programs:
1. Qualified Medicare Beneficiary (QMB) Program helps pay for Part A and/or Part B premiums, deductibles, coinsurance, and copayments.
2. Specified Low-Income Medicare Beneficiary (SLMB) Program will help you pay for Part B premiums (only).
3. Qualifying Individual (QI) Program helps you pay for your Part B premiums (only). You must apply for this each year. The benefits and the applications are granted on a first-come first-served basis.
4. Qualified Disabled and Working Individuals (QDWI) Program helps you pay Part A premiums (only). You may qualify for this program if you have a disability and you are working.
Program of All-Inclusive Care for the Elderly (PACE) is a Medicare/Medicaid program that helps people meet health care needs in community.
With this Medicare + Medicaid program, a team of health care professionals will provide coordinated care to help you meet your health care needs at home, instead of in a nursing home or elderly care facility.
State Pharmacy Assistance Programs (SPAPs) are available in many states to help certain people pay for prescription drugs based on financial need, age, or medical condition.
Click HERE to see which states have a State Pharmacy Assistance program (SPAP).
In the State of Nevada, the State Pharmacy Assistance Program, Senior Rx, provides financial relief to those who cannot afford their monthly premiums or the high cost of prescription drugs when they are in the donut hole. Qualifications include: