Some Medicare acronyms that could save you money


This is about Medicare – again. ’Tis the time of the season for Medicare, because “open enrollment” for Part D and Advantage Plans began six days ago (Oct. 15) and will run through Dec. 7 (a day that will probably live in infamy); regardless, here we are.

So (again), if you’re not on Medicare, about to be and don’t know anyone you like who is, feel free to go immerse yourself in some frivolous pursuit that might actually nudge you to the brink of mental health. The rest of us have work to do and today that “work” might save a number of us a considerable amount of money.

As threatened last week, today we’re going to venture into a land of acronyms generally referred to as “Medicare Savings Programs.” I’ll quote the acronyms and tell you what they stand for, because if I don’t, some of you will feel sufficiently neglected to warrant emailing me, demanding to know what they stand for; however, it is NOT important that you remember said acronyms, nor is it important that you remember what they stand for. It IS important that you pay enough attention to the numbers to see if they will do you or yours some good.

Acronym #1 is QMB (pronounced “Quimby”), that stands for “Qualified Medicare Beneficiary.” If you qualify for it, it will pay for your Part A premium (if you have one), your Part B premium (I’m pretty sure that you have one of those) AND your Part A or B deductibles, copays or coinsurances. If you have an Advantage Plan, QMB will pay copays and coinsurances for medical and hospital care.

Did you follow that? Did you see the part about it paying your Part B premium? So, without even trying, we’ve just saved you real close to $1,200! – Indeed, Quimby is our friend.

You qualify for QMB if your income as a single person is at or below $931 per month and your “assets” are at or below $6,940. “Assets” means cash, bank accounts, stocks, bonds, real estate contracts, blah blah – Pretty much what you’d think it means. It does NOT mean your house, one car or your stuff; also, if you have up to $1,500 set aside in a specific account for burial costs, that isn’t counted, either.

If you’re a couple, income at or below $1,261 per month, assets at or below $10,410.

FYI, if you qualify for QMB, you AUTOMATICALLY qualify for the Part D “extra help” (“L.I.S./Low Income Subsidy” – I went on about this last week), so you’d have very low to $0 premium, $0 deductibles and very low copays and, probably, no donut hole.

See? Quimby is our friend.

Acronym #2 is SLMB (pronounced “Slimby”), that stands for “Specified Low-Income Medicare Beneficiary” (feel smarter?). If you qualify for this, it’ll pay your Part B premium only (again, do the math in your head – real close to $1,200/year, right? Right!) To get in the game, for a single person, income at $1,117 per month, assets the same: $6,940; for a couple, income at $1,513 per month, assets the same at $10, 410.

Acronym # 3 is QI-1 (pronounced “QI-1”), which stands for “Qualified Individual” (I know, but I don’t make them up). QI-1 will pay for your Part B premium only. Income for a single person at or below $1,257 per month, assets the same at $6,940, and for a couple, income = $1,702 per month, assets the same at $10,410.

I know what you’re thinking, and No: You did NOT misread something – YES, I just referenced two acronyms that both pay your Part B premium, with different income levels, so you’re thinking, “WHY?”

Answer: I don’t know. I probably knew once, but I don’t know now; more importantly, I don’t care. I DO care that people without a lot of money get the help.

Now, a handful of you are, for lack of a more pejorative term, “policy wonks,” so you’re thinking, “You can’t fool me, Harvey! ‘Medicare Savings Programs’ are a form of Medicaid, which means that ‘they’ will come after my estate!”

First, I’m not in the business of “fooling” you – If I were, we’d call this “Fool Line,” and we don’t.

Second, you’re right about these being a form of Medicaid; however, Medicare Savings Programs are NOT “recoverable” under Medicaid, so you have nothing to lose (Score one for my side!).

So, what do you actually do? Well, you can come to any of the SHIBA clinics that I listed last week or you can call any of the numbers at the end of this column for help.

You can go online to http://www.dshs.wa.gov/onlinecso/findservice.shtml or you can truck on down to the nearest DSHS office (You want the “CSO,” which stands for “Community Services Office”). FYI, it really isn’t all that tough to get signed up, so just keep repeating to yourself, “$1,200, $1,200, $1,200…” but do it silently, so people don’t look at you oddly.

I know this stuff can glaze you over – me, too; but the fact is that they can save us serious money in a time when pretty much any money is “serious,” so read this two or three times, then DO IT, because waiting or “thinking about it” won’t help you or anybody else.

$1,200, $1,200, $1,200…Mental health be damned.

Mark Harvey is the director of Senior Information and Assistance for Olympic Area Agency on Aging. He can be reached at harvemb@dshs.wa.gov or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information & Assistance.