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Do you need help paying your Medicare expenses?

If you are a low-income Medicare beneficiary, the Medicare Premium Assistance Programs (MPAP) may help you pay some or all of your Medicare cost-sharing expenses (premiums, copays, and coinsurance). MPAP is part of the Ohio Medicaid program. MPAP is sometimes called the “Medicare buy-in” or “Medicare savings” program. All of these names refer to four subprograms:

  1. the Qualified Medicare Beneficiary (QMB) program;
  2. the Specified Low-Income Medicare Beneficiary (SLMB) program;
  3. the Qualified Individual-1 (QI-1) program; and
  4. the Qualified Working Disabled Individual (QWDI) program.
MPAP will pay different costs for you if you are eligible for one of the four subprograms:

  • QMB will pay all your copays, coinsurance, and monthly Parts A and B premiums.
  • SLMB and QI-1 will pay your monthly Part B premiums.
  • QWDI will pay your monthly Part A premiums.

In addition, if you are eligible for QMB, SLMB or QI-1, Social Security will automatically enroll you in its Extra Help program. For 2017, Extra Help limits your Part D prescription copays to no more than $3.30 for each generic drug and no more than $8.25 for each brand-name covered drug.

Each subprogram has different income limits, and other eligibility requirements. For 2017, the income limits for individuals are:

  • $1005 monthly for QMB (100% FPG);
  • $1357 monthly for SLMB and QI-1 (135% FPG); and
  • $2010 monthly for QWDI (200% FPG).

The asset limit is $7390. But, only some income and some assets are counted; and different limits may apply depending on your circumstances. So, you should apply, have the county make an eligibility determination, and then seek advice or appeal if you disagree with the county’s decision. Legal Aid may be able to help you. To be connected to the nearest Legal Aid office, phone (866) 529-6446 (LAW OHIO).

You may apply for MPAP at your local County Department of Job and Family Services, sometimes called the “county welfare department” or “county Medicaid.” For the address of the nearest office, phone the Medicaid Consumer Hotline at (800) 324-8680.

This article was written by Bob Bonthius and appeared in The Alert: Volume 33, Issue 1 and reprinted with permission from The Alert, a publication of The Legal Aid Society of Cleveland.

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