Montana Medicare insurance is a federally funded program available to all states. It is designed to provide affordable and adequate health insurance coverage for qualified beneficiaries over the age of 65. Workers with disabilities may also qualify. In a state like Montana where the average cost of premiums is $55 per month, the chance to pay only $134 a month is welcome news for many residents.
While Medicare is a federal program, the state of Montana also offers various types of support and assistance for Medicare beneficiaries in the state.
In many ways, Medicare offers adequate coverage for a reasonable cost. Qualified beneficiaries can obtain Original Medicare from Medicare directly, and this is comprised of Medicare Part A and Part B.
Medicare Part A is normally premium-free, and it covers hospital services including inpatient care. Medicare Part B requires a premium depending on the beneficiary’s income, with a premium of $134 a month for an annual income of less than 85,000. Both Medicare Part A and Part B involve out-of-pocket expenses such as deductibles, copays, and coinsurance.
Some beneficiaries feel that Original Medicare does not offer enough coverage, and they have the choice to purchase optional supplemental plans to add more benefits to Part A and Part B. These may be plans that cover extra health services that are not covered by Medicare Part A and Part B.
A more common type of supplemental plan covers the cost of Medicare prescription drugs. This is called Medicare Part D and can be added to Part A and Part B. Other plans may instead cover the costs of deductibles, coinsurance, and copays involved with Original Medicare.
All these plans can be purchased from private carriers, which have been approved by Medicare. These will entail the payment of a separate premium as well.
Instead of obtaining Original Medicare, qualified beneficiaries may instead opt to purchase Medicare Advantage Plans. These include coverage that Original Medicare provides, as well as the coverage that a supplemental plan may offer. This type of Medicare plan is also known as Medicare Part C. The extra benefits can be coverage of additional health services or coverage for prescription medication.
The Montana Human & Community Services Division offers numerous programs and services, and these include the Medicare Savings Programs (MSP) that offer eligible Medicare beneficiaries to receive assistance in paying for Medicare costs. These programs come with several requirements, including limits on income as these programs are meant only for low-income applicants.
The first Medicare Savings Program is for Qualified Medicare Beneficiaries (QMB). This program pays for Medicare Part A and Part B premiums, as well as for deductibles, copays, and coinsurance. To be eligible, an individual can have an income of no more than $1,032 a month. (Technically this limit is $1,012 a month, but the first $20 of the income is not counted.) For an applicant who is living with their spouse, the limit for their combined income is $1,392.
The next MSP is for Specified Low-Income Medicare Beneficiaries, and this SLMB program covers the cost of Medicare Part B premiums. An individual cannot earn more than $1,234 a month, while the income limit for a married couple is $1,666.
The program for Qualified Individuals (QI) also pays for Medicare Part B premiums. However, the funding for this program is more limited, and application is granted on a “first come, first served” basis. The benefits continue until the program runs out fi funding.
Another program is for Qualified Disabled and Working Individuals (QDWI). This pays for the premium for Medicare Part A. However, this is not a Medicare Savings Program. It is part of Medicaid, and the beneficiary cannot benefit from both the QDWI program and another Medicaid program.
Those who are eligible for the QMB, SLMB, and QI programs may also be eligible for the Extra Help program. This pays for Medicare Part D, to cover the costs of prescription medications. An individual can qualify with an income of less than $18,090 per year and resources totalling less than $13,820. For a married couple, the limits are $24,360 for income and $27,600 for resources.
Montana runs a State Health Insurance Assistance Program that offers free and unbiased counselling regarding Medicare. To contact SHIP, Montana residents can call 1-800-551-3191.