Save Money on Your Out-of-Pocket Medicare Costs
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The Medicare Savings Program (MSP) and the Extra Help/Low Income Subsidy program for prescription drugs are a state and federal benefit designed to help low-income Medicare beneficiaries pay for their out-of-pocket Medicare costs.
The Medicare Savings Program helps pay for the Part B premium, which, in 2023, is $164.90 each month, resulting in the potential to save approximately $2000 a year. Depending upon which level of the MSP program you qualify for (see below), the program may also cover deductibles, co-payments, and co-insurance payments.
Each state offers a Medicare Savings Program, but the eligibility guidelines vary by state. Some states require both an income and an asset limit; however, in Connecticut, only an income limit is considered for eligibility. Due to the high cost of living in Connecticut, the state has one of the most generous income limits to qualify for the program.
All individuals who qualify for the Medicare Savings Program are automatically eligible for the Extra Help/Low Income Subsidy program (LIS) for prescription drugs. In 2023, this program caps generic drugs at $4.15 and brand-name drugs at $10.35 on your plan’s formulary. While many Medicare beneficiaries may pay less than these amounts for their drugs, the point is that one would not pay more than this amount, which is particularly valuable when it comes to expensive brand-name drugs. A benefit of the LIS program includes the ability to have a Special Enrollment Period that permits you to switch plans quarterly (except for the final quarter). In addition, one is not subject to a late enrollment penalty if one did not enroll in a prescription drug plan when first eligible. Please note that LIS does not replace a prescription drug plan.
To be eligible for the Medicare Savings Program, one must have Medicare Part A and fall within the income eligibility guidelines listed below. The program works with both Original Medicare and Medicare Advantage Plans. It does not replace your current insurance. To learn more about the program, contact a CHOICES Counselor at the Western CT Area Agency on Aging at 1-800-994-9422 or 1-203-757-5449. All languages are welcome.
Sources: https://portal.ct.gov/DSS/Health-And-Home-Care/Medicare-Savings-Program/Medicare-Savings-Program/Related-Resources and https://ncoa.org/article/what-are-medicare-savings-programs-msps
This article is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS), as part of a financial assistance award totaling $242,173 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.
This article was written by Amanda Asch Halle, Interim Regional Coordinator at the Western CT Area Agency on Aging.