The average health insurance premium in Maine is $556 per month, and expectedly, a significant number of residents cannot afford it. If you find regular insurance plans too expensive for your budget, there are programs available such as Maine Medicare Insurance.
Medicare is a federal program that helps pay for the costs of health care services. Most beneficiaries of this program are over the age of 65, but some workers with disabilities may qualify as well. The program is not as expensive as private insurance plans, and the state of Maine also offers various public assistance programs to assist Medicare beneficiaries.
Medicare at its core is made up of Medicare Part A and Part B. Together, they’re called Original Medicare. Medicare Part A deals with hospital services and services in similar healthcare facilities, and they cover inpatient hospital care. Medicare Part B enables beneficiaries to receive medical treatments, durable supplies, and preventive services that are all regarded as medically necessary.
Medicare Part A typically does not require beneficiaries to pay monthly Medicare premiums, although there are some exceptions to this. Medicare Part B normally has beneficiaries paying a monthly premium, but the amount depends on the annual income of the Medicare beneficiary. For those who earn less than $85,000 a year, the premium is $134 a month. Both Medicare Parts A and B have deductibles, coinsurance, and copays.
Some private health insurance carriers in Maine have been authorized by Medicare to offer Medicare Advantage Plans, which are also known as Medicare Part C. This plan provides the same coverage as the combined Medicare Part A and Part B, and it also generally covers some other services that are not covered by Original Medicare.
Other options are supplemental plans that are purchased to add more covered services to what Original Medicare provides. A common example of this is the Medicare Prescription Drug Plan, which is also known as Medicare Part D. As many Medicare beneficiaries are senior citizens who require numerous medications, this type of plan can significantly cut down on the cost of healthcare.
Some beneficiaries may also opt for supplemental plans that provide more coverage benefits to add to Original Medicare. These plans may even cover the cost of deductibles, coinsurance, and copayments.
If you’re a resident of Maine and you’re having difficulties covering the cost of Medicare, the state offers 2 Medicare Savings Programs (MSP) to alleviate the financial burden. Qualifying for any of these MSPs will require meeting income and asset limits.
The Qualified Medicare Beneficiary Program or QMB will pay for all mediocre premiums. This also covers coinsurance and deductibles, and reduces the cost of generic prescription drug copayments.
An individual can qualify for the QMB program with a monthly income of no more than $1,492 a month, while their liquid assets (savings and checking accounts, stocks, and bonds) should not total more than $58,000. A married couple may also be eligible with a combined income of less than $2,021 per month. Their combined liquid assets should be less than $87,000.
The other program is the Specified Low-Income Medicare Beneficiary (SLMB) program, which is also called the Qualified Individual (QI) program. The SLMB or QI program covers the premium for Medicare Part B and Part D, along with the deductibles and coinsurance. Generic drug copayments are also reduced.
To qualify for this, an individual should earn no more than $1,846 per month while liquid assets should be less than $58,000. Married couples have an income limit of $2,501 per month and an asset limit of $87,000.
These are not hard limits, and these income and asset limits may be raised depending on circumstances. An applicant’s income may be raised if they are working, or if only one spouse of the married couple is working.
Aside from the MSPs, there is a Qualified Disabled and Working Individual Program that helps cover the cost of Medicare Part A premiums. Another option is the Extra Help program, which may help cover the cost of Medicare Part D if the applicant is within income and asset limits.
Finally, there is the Maine Rx Card Program, which is absolutely free and available to Maine residents. This program offers the lowest pricing and discounts on medications, which can save members an average of 30% off prescription drug expenses.
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