Iowa Medicare Insurance can cover the costs of health care services for those beneficiaries who qualify. It is generally for people over the age of 65, although workers with disabilities may qualify as well. Medicare is federally funded, but the state of Iowa offers various assistance programs for its beneficiaries.
Medicare comes in various forms, including plans from private carriers. Original Medicare is made up of Medicare Part A and Medicare Part B. The Medicare Part A covers the cost of hospital insurance, including inpatient hospital care and home health services. Medicare Part B involves various medical services and supplies considered medically necessary and includes preventive services.
Most beneficiaries of Medicare do not have to pay for Part A premiums if they have worked and paid taxes for at least a decade. However, in some cases of short employment records, premiums may be required. Medicare Part B normally require the payment of premiums which are based on annual income levels. The lowest income level requires a monthly premium payment of $134 a month. Both Parts A and B can have deductibles and coinsurance payments.
Some people may opt to obtain their Medicare plans from private carriers that have already been approved of by Medicare. These carriers can offer Medicare Part C plans, which combine the coverage of Medicare Part A and Part B. Otherwise known as Medicare Advantage plans, these health plans offer the “advantage” of providing coverage for some health care services not include in the Original Medicare coverage.
Other types of Medicare Plans are supplemental, which Medicare beneficiaries may obtain to add to their Part A and Part B coverage. One common example of these is known as Medicare Part D, which covers the cost of Medicare prescription drugs.
Medicare Supplemental plans can provide coverage for more services that are not part of the Original Medicare coverage. Other plans can help pay for the costs of deductibles and copayments required with Medicare Parts A and B.
All these plans require the payment of premiums. With supplemental plans, the premiums are an additional expense to the premiums required by Medicare Part A and Part B.
Iowa runs a Medicaid program that offers financial assistance for health insurance costs to those with limited income. These include the Medicare Savings Program (MSP) that can cover the cost of Medicare for qualified applicants. The financial assistance depends on many factors, including the income of the Medicare beneficiary.
This starts with the Qualified Medicare Beneficiary program or QMB. With this program, Iowa Medicaid pays for Original Medicare premiums for both Parts A and B, along with the associated deductibles and coinsurance payments. To qualify, an individual’s monthly income must be less than $1025, while a married couple can be eligible with a combined income of $1,374 a month.
These figures are for 2017, but in general, the QMB program has a limit of 100% of the Federal Poverty Level. In 2018, the FPL is set at an annual income of $12,140 per year for an individual. A household or two (such as a married couple) has a combined income limit of $16,460 per year.
The next tier is the Specified Low-Income Medicare Beneficiary (SLMB) program. This pays for the premium for Medicare Part B, which in a year can total $1,608. The income limit is greater than 100% FPL but less than 135% of the FPL. For 2018, the 135% FPL for an individual is a maximum annual income of $16,389. This is raised to $22,221 per year for a household of 2.
Those who qualify for this for the QMB or the SLMB program can also qualify for Extra Help program. This is a low-income subsidy program to help beneficiaries cover the prices of prescription medication. To qualify, an individual must earn no more than $18,210 a year and have resources totaling less than $14,100. For a married couple, the ceilings are $24,690 for income and $28,150 for resources.
Iowa has the Senior Health Insurance Information Program (SHIIP) to offer counseling and advice to Medicare beneficiaries. To contact Iowa SHIIP, call 1-800-351-4664. Counselors are available to provide one-on-one counseling for any matter regarding Medicare.
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