By Kay Kaylor
PREVIEW Columnist
I advocate for residents in extended care and assisted living residences as the region’s lead long-term care ombudsman. I also am a Senior Medicare Patrol and State Health Insurance Assistance Program (SHIP) counselor. Information on the many aging and care concerns will be included here.
Through Colorado Medicaid (Health First), Medicare Savings Programs (MSP) help some Medicare beneficiaries pay for Part B premiums and, for people with more limited income and resources, for copays and deductibles. Through the Social Security Administration, the federal government offers Extra Help programs for Part D prescription drug plan premiums. According to research, numerous people who could be using these options are not taking advantage of them.
Each year in early spring, the income and asset limits for these programs change based on the Federal Poverty Level. Some details are given in the “Medicare and You” booklet sent to beneficiaries and on the website Medicare.gov. SHIP counselors can also explain them and assist in applying for Extra Help. The case workers at Archuleta County Department of Human Services on Hot Springs Boulevard screen people for MSP eligibility. The asset limits do not include your primary residence and one vehicle.
The full complexity of these benefits cannot be explained here. For example, specific income and wage amounts are not counted for MSP, so it is worth applying if your income and assets are close to the amounts given in the following summary.
For Partial Extra Help in 2020, the monthly income must be below $1,615 for individuals and $2,175 for couples, with assets up to $14,610 for individuals and $29,160 for couples. For Full Extra Help, the monthly income for individuals must be $1,456 and below, with assets up to $9,360, and, for couples, an income no more than $1,960 and assets up to $14,800. Both programs have prescription copays with a maximum of $6,350 in expenses annually. The Full Extra Help copays are $3.60 for generic and $8.95 for brand-name drugs.
MSP has three categories with monthly income limits ranging from $1,084 to $1,456 for individuals and $1,457 to $1,960 for couples. The asset limits decreased to $7,860 for individuals and $11,800 for couples. Those who qualify for MSP automatically qualify for Full Extra Help.
The San Juan Basin Area Agency on Aging offers resources for people age 60 and older or on Medicare. For further information, please call or text 403-2165 or send an email to leadombudsman@sjbaaa.org.
