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You may be eligible for help in paying for some of your Medicare costs!

Did you know that you may be eligible for help in paying for some of your Medicare costs…including your monthly Medicare Part B premium?

Ohio’s Medicare Savings Programs (formerly “buy in” programs or premium assistance programs) provide financial assistance to individuals that are eligible for Medicare, have assets that do not exceed program limits, and the family’s income is:

  • Below 100% of the Federal Poverty Level (FPL):
    • May be eligible for Qualified Medicare Beneficiaries (QMB) that pays your Medicare Part B premium AND Medicare out-of-pocket expenses that includes your Medicare Part A deductible and your 20% of Medicare covered services.
  • Between 100% and 120% of the FPL:
    • May be eligible for Specified Low-Income Medicare Beneficiaries (SLMB) that pays your Medicare Part B premium.
  • No more than 135% of the FPL:
    • May be eligible for Qualified Individuals-1 (QI-1) that pays your Medicare Part B premium.

Please note that as of December 1, 2015, the Ohio Department of Medicaid expanded the definition of “family” when determining whether or not an individual meets the income requirements for this assistance.  If you were previously denied coverage because your income was too high, but you have a spouse and/or children in your home, you should reapply for assistance

You can apply for coverage at your local CDJFS or call the Ohio Department of Medicaid at (800) 324-8680 and request an application.  The form is also available online at http://medicaid.ohio.gov/RESOURCES/Publications/MedicaidForms.aspx.  There is no face-to-face interview requirement.  You just need to complete the application and mail it back with proof of identification, age, citizenship, income and resources.

If you are denied or terminated from coverage, you may appeal by requesting a state hearing within 90 days from the date of the denial or termination.  If your benefits are terminated and you request a state hearing within 15 days of the notice, you may choose to receive on-going benefits. You can appeal by contacting the Bureau of State Hearings by telephone at (866) 635-3748, by e-mail at , by fax at (614) 728-9574 or by mail at ODJFS Bureau of State Hearings, P.O. Box 182825, Columbus, OH 43218-2825.

Ohio’s Medicare Savings Programs are administered by the Ohio Department of Medicaid though the local County Departments of Job and Family Services.

 

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