Under the Medicare Savings Programs, state Medicaid programs help pay for premium and/or cost-sharing assistance for Medicare beneficiaries who have income and assets below certain levels, up to 135 percent of the federally defined poverty level.
This year, that income level is $18,347 for individuals and $24,719 for couples; the asset limits are $8,400 for individuals and $12,600 for couples. In most cases, people eligible for the program also qualify for full Medicaid benefits, which can include long-term care and dental and vision care.
Under the Extra Help program, the federal government subsidizes premiums, deductibles and cost sharing for Part D prescription drug benefits. The assistance varies according to income level — up to $20,385 for individuals and $27,465 for couples this year. The asset limit is $14,010 for individuals and $27,950 for couples.
States expanding Medicare help
Some states have expanded eligibility for their Medicare Savings Programs — as of last year, 15 did so, along with the District of Columbia, according to the Medicare Payment Advisory Commission, an independent Congressional agency charged with advising lawmakers on Medicare.
New York raised its income eligibility as part of a broader move to expand access to Medicaid for seniors and disabled people. Benefits will be extended to people with incomes up to 186 percent of the federal poverty level, up from 135 percent. Beginning on Jan. 1, 2023, a single person with monthly income of $2,107 will qualify, up from $1,529 (for married couples, the comparable income maximum will be $2,838, up from $2,060) according to a Medicare Rights Center estimate. The state eliminated its asset ceiling in 2008.
Much of the expansion in New York State will take advantage of federal subsidies.
In 2020, Massachusetts expanded income eligibility, and doubled the asset limit to $15,720 for an individual and $23,600 for couples. The state’s governor, Charlie Baker, is proposing to further expand income eligibility in 2023.
And California will increase its asset test from $2,000 to $130,000 beginning on July 1 this year — and phase out the test entirely in July 2024. California increased its income eligibility in 2020. This year, the income qualification for the state’s lowest-income beneficiaries is $13,590 for an individual and $18,310 for a married couple.