09/20/2021
How to Really get the Medicare Savings Program â YES ITâS A REAL PROGRAM
I realized after my initial post last week I needed to do better to explain this process to protect seniors on Medicare or individuals on SSI Disability who can also qualify for this program. As I have personally completed over 1000 of the Medicare Savings Program applications over the past 10 years, I wanted to explain this process from start to finish.
I am going to do my best to provide just information for you to share. I would encourage you to fact check what I post with info from Medicare, Social Security, and Texas Health and Human Service.
I am tired of telemarketing calls to not only my members but to seniors across the county and the best way for me to fight back is to share the facts of what I see from my experience in this industry over the past 10+ years. You do not have to call me for Medicare coverage, to enroll in a plan or anything else. If there is anything I hope to do it is to educate people and their families to not getting taken advantage of.
I personally hold Medicare responsible for some of this as they Must spot check these telemarketing firms calling seniors non stop who are on the DNC (do Not Call List) to stop this. If you have a question, I am happy to answer it, tell you I donât know, or hunt down the information to increase my knowledge to share with others. Thank you for taking time to read this. If you see this and you donât care about any of this, I apologize if I could remove it from your feed forever, I would đ
The Medicare Savings Program is a real program offered to Seniors single or married that fall below specific income parameters. See attached sheet â in the 2021 Medicare and you book it is on page 90 in the 2022 Medicare and you Book it is on page 94. You can also google âMedicare and your bookâ to see for yourself!!
Facts to qualify
1. Single - monthly income needs to be below $1449 Hawaii/Alaska are higher (see attached sheet)
2. Married gross income needs to be below $1960 Hawaii/Alaska are higher (see attached sheet)
a. Gross assets in bank and CDâs must be below $7970 for single and $11,960 for married couples
b. The state waives your house and one car as an asset
3. The State of Texas has up to 45 days to say yes or no to qualify you
4. To qualify you minimally need to send HHSC most recent 90 days bank statements â copy of life insurance if you have any (again this is minimal documents you must send in)
a. You will be declined without these docs as your enrollment will be denied for incomplete
Ways to Apply:
1. Call 211 to do over the phone
2. Walk into an HHSC office in your city
3. Use your Medicare plan if they have a third party that does it â not everyone carrier does â and frankly itâs not as easy as it sounds as I tried this route this year. âMy Advocate and Premium assist are two third party agencies that do it for carriersâ
4. Apply online at yourtexasbenefits.com
5. Ask your current agent if they provide this service
Insurance agents/ call centers do not get paid to do these enrollments so less than 2% of agents help members with these services.
From what I have gathered from my members, other agents, and managers are The Joe Namath commercials and other related commercials that advertise for the $148 giveback are transferred to a call center when called.
I am sure not all call centers are doing this and some may help members. However the advertisement for the $148 in my opinion is misleading.
For the members of mine and people you may know who have been changed this is what i have been told. What my members have told me are seniors are being told they qualify for the $148 giveback. They are asked multiple questions, and then told their plan starts the 1st of the next month.
RED FLAG: the state of Texas needs minimally needs the most recent 90 days or bank statement and life insurance info the application would be denied. If the call center is not asking you for this information, you will NEVER BE APPROVED. The call center would also need this to send in with your application!!!
What happened: The questions asked were to move you from one Medicare plan to another. You receive a new card in the mail from a new Medicare plan and you donât know why. From what my members told me they thought they were applying for the $148 giveback but were really getting moved from there plan. This affected their doctors and their meds for the next 1-3 months.
How to fight back: Call Medicare â they have the power to cancel what the call center did and move you back to the plan you had. If you have an agent, they can help you move back as well. If you do call Medicare file a complaint against the call center at the same time. Medicare needs to listen. Medicare is open 24 hours a day so call after 8pm and your hold time should be under 10 minutes. 1-800-623-4227.
There are some Medicare Advantage plans that provide $50-$125 giveback (approximately) per month back of your part B Premium. This can work great if you have Medicare Part A&B and go to the VA for your Medical care. Or if you are healthy (currently). Where you could face larger out of pocket expenses are if you have medical conditions as the co-pays on the plan are higher than the plans that donât provide the giveback.
So in close BE CAREFUL who you give your info to- if you are giving your Medicare card info to someone over the phone or to someone in person it means you are DIS-ENROLLING FROM YOUR CURRENT PLAN â this could affect your doctors, medications, and specialists if you are not careful.
A good agent will verify your doctors, specialists, Medications, and what your needs are. They will compare them to you off Medicareâs website and show you the differences of the plans so you can make an informed decision on what is best for you.
If they arenât giving you a comparison of Medicare.gov they may not offer the plan that is best suited for you! They may only be showing you the 1-2 plans that they offer.
My suggestion is to talk to your family and friends and see if they have an agent that they are happy with that follows up with them within a reasonable time to help them as needed. There are good agents out there to serve you and make sure you are getting the plan right for you.
I wish you the best and be careful!!!
Jack Barnum