The average cost of health insurance premiums in Michigan is $467 per month, and that may be too expensive for many of its residents. However, Michigan Medicare insurance exists to provide more affordable health insurance coverage. It is mostly designed to help its citizens who are over the age of 65, although some workers may qualify if they have certain disabilities.
Medicare is a federal program, though Michigan has state programs to help Medicare beneficiaries in the state. One way to obtain Medicare coverage is to obtain Original Medicare, which is run by Medicare itself.
Original Medicare is made up of Medicare Part A and Part B. Part A is typically free from premiums (with a few exceptions) and covers hospital services such as inpatient care. Medicare Part B normally requires a premium, and it covers medically necessary treatments and medical supplies. Both these programs have deductibles, coinsurance, and copayments.
Private health insurance carriers that have been approved by Medicare can offer Medicare Supplemental plans for beneficiaries to obtain additional coverage that are not part of Medicare Part A and Part B. The plans may also cover the deductibles and other out-of-pocket expenses that Medicare coverage may require.
One type of supplemental plan is the Medicare Prescription Drug Plan, which is also known as Medicare Part D. This plan can lower the price of prescription drugs and makes Medicare coverage much more comprehensive.
Instead of Original Medicare obtained from Medicare itself, beneficiaries can opt to get Medicare Advantage Plans from private carriers that have been approved by Medicare. These plans are also known as Medicare Part C. They offer all the benefits of Original Medicare, plus additional benefits such as more healthcare services covered. Also, these plans may also include coverage for prescription medication.
Michigan residents can apply at their local Department of Human Services (DHS) to qualify for any of the Medicare Savings Programs. These programs may cover all or some of the costs of Medicare, and the level of assistance will depend on the income and assets of the Medicare beneficiary.
The Qualified Medicare Beneficiary (QMB) program pays for the cost of premiums, deductibles, coinsurance, and copayments of both Medicare Part A and Part B. To qualify, an individual cannot earn more than $1,032 a month. Married couples have a combined monthly income limit of $1,392.
The Specified Low-Income Medicare Beneficiary program (SLMB) pays for the premiums for Medicare Part B. That saves a Medicare beneficiary at least $1,600 for the year. An individual is eligible with an income of less than $1,234 per month, while a married couple should earn a combined income of no more than $1,666.
The QI (Qualified Individual) also pays for Part B premiums, but the funding is less secure. To qualify, an individual’s income per month should be less than $1,386. For married couples, the income cannot exceed $1,872.
These QMB, SLMB, and QI programs also require qualified applicants to have assets worth less than $7,560 for an individual. The asset limit is $11,340 for a married couple.
Qualifying for these programs may also make you eligible for the Extra Help program, which is also called the Low-Income Subsidy (LIS). This helps pay for Medicare Part D. An individual needs to have an annual income of less than $18,090 and total assets of less than $13,820 to qualify. For a married couple, the income limit is $24,360 while the resource limit is $27,600.
Finally, there is also the program for the Qualified Disabled and Working Individuals. The QSWIs are under 65 who lost their access to premium-free Medicare Part A when they went back to work. To qualify, an individual must earn a monthly income of no more than $4,132 while a married couple’s combined income cannot exceed $5,572 a month. Individuals are also limited to $4,000 in resources, while this limit for married couples is $6,000.
The law requires every state to set up an organization that provides counselling and answers about Medicare. In Michigan, this is called the Medicare/Medicaid Assistance Program or MMAP. The service is completely free with no need to provide personal information. The counsellors also have no ties to any private health insurance companies.