Illinois residents have to contend with a high cost of health insurance, with an average premium of $559/month. More affordable health insurance coverage is available for qualified beneficiaries of Medicare, however. Illinois Medicare insurance helps cover the cost of health care services at a much lower rate.
Most qualified Medicare beneficiaries are over the age of 65, although some are eligible if they have a disability. This is a program funded by the federal government, although the state of Illinois offers various assistance programs for the state’s Medicare beneficiaries.
In its basic form, Original Medicare is made up of Part A and Part B. Hospital services such as inpatient care are covered by Medicare Part A, which rarely requires a premium. The Medicare Part B typically requires a monthly premium of at least $134 per month, and this part of Medicare covers medically necessary treatments and supplies. Both Medicare Part A and Part B will involve deductibles and copayments.
Some carriers in Illinois have been approved by Medicare to provide Medicare plans for qualified individuals. In general, these plans offer improved or additional coverage beyond the scope of Original Medicare.
With Medicare Advantage Plans, beneficiaries receive the combined coverage of both Medicare Part A and Part B. These plans typically also cover other healthcare services that Original Medicare doesn’t cover. This type of Part A and Part B combination is also known as Medicare Part C.
There is also a Medicare Part D plan, and this covers the cost of prescription medication. This is an important type of coverage for many Medicare beneficiaries in Illinois, as prescription drugs for the elderly can be numerous and expensive. These Medicare Prescription Drug Plans can be purchased to supplement the coverage of Original Medicare.
Other Medicare Supplemental Plans can also be obtained to cover the costs of deductibles and coinsurance payments. These plans may also cover additional health care services that aren’t covered by Original Medicare.
The Illinois Medicaid program includes various Medicare Savings Programs (MSP) to help beneficiaries pay for the costs of Medicare. These programs offer various levels of financial assistance depending on the income level of the applicants.
For the Qualified Medicare Beneficiary (QMB) Program, all the premiums for both Medicare Part A and Part B are paid for. Also, it can also cover deductibles and copayments. To qualify, an individual must earn an income of no more than $1,025 per month. An applicant who is living with a spouse can be eligible with a combined household income that doesn’t exceed $1,374.
The Specified Low-Income Medicare Beneficiary (SLMB) program pays for the Medicare Part B premium. This may not seem like much, but this can provide beneficiaries with savings of $1,608 per year. To qualify, SLMBs must not earn more than $1,226 a month while a married couple has an income limit of $1,644.
The program for Qualified Individuals (QIs) has the same benefit as the SLMB program, but because of funding issues the beneficiaries are prioritized on a “first come, first served” basis. This program accepts QIs with an income less than $1,377 a month, with married couples limited to a combined monthly income of $1,847.
All the qualified beneficiaries for the QMB, SLMB, and QI programs can also apply for Extra Help. This is the Low-Income Subsidy program that can assist in covering the cost of prescription medication. Qualified members have an annual income of less than $18,090 with resources also limited to $13,820 at the most. For married couples, the ceilings are $24,360 for income and $27,600 for resources.
Another program also offers assistance in paying Medicare Part A premiums. To qualify, an individual must have a recognized disability and is not receiving Medicaid benefits. The monthly income limit is $4,105 for an individual and $5,499 for married couples.
Many Medicare applicants and beneficiaries understandably have numerous questions regarding the program. For answers, they can turn to the Illinois State Health Insurance Program (SHIP) which offers objective advice without selling or soliciting any type of insurance. Medicare questions can be answered with a phone call to Illinois SHIP at (800) 252-8966.
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