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Mass Health offers "Medicare Buy-In"
coverage
Senior Buy-In Program offers financial assistance to Medicare beneficiaries,
few of those eligible enrolled
By Linda Lissack
Did you know that financial assistance is available to help elderly and disabled persons
pay for their premiums and out-of-pocket costs under the Medicare program? Well, if you
have never heard of the "Senior Buy-In," or "Qualifying Individual"
programs, you are not alone. According to federal government estimates, no more than half
of those eligible for these benefits are presently enrolled.
"Senior Buy-In" and "Qualifying Individual" are federal programs that
help persons access Medicare benefits. Depending on one's eligibility category, the buy-in
coverage can pay for Medicare's monthly enrollment premiums, as well as deductible and
co-insurance costs. While the program is administered in Massachusetts by the state
Division of Medical Assistance ("Mass Health"), you do not have to be Medicaid
-eligible to qualify. In fact, the program is designed for persons who have limited
financial means, but who are not considered poor enough to qualify for full Medicaid
assistance.
Benefits Offered, Who is Eligible, and Where to Enroll: The following chart details the
benefits offered and financial eligibility limits for 2000, for the Senior Buy-In and
Qualifying Individual programs:
Senior Buy-In Buy-In Qualifying
Qualifying
Individual-1
Individual-2
Income Limit: $716/Month $855/Month
$960/Month $1238/Month
Single
Income Limit: $958/Month $1145/Month
$1286/Month $1661/Month
Couple
Asset Limit: $4,000 $4,000 $4,000
$4,000
Single
Asset Limit: $6,000 $6,000 $6,000
$6,000
What it Pays For: Medicare Part B
Part B Part B
Premiums, Premiums Premiums
Premiums
Deductibles, and
Partial
Co-Insurance
Amounts
Some important Notes:
When counting income, remember to add the amount of your Medicare B premium (currently
$45.50) back into your Social Security income amount. If you are currently working, part
of your earnings will be excluded from the income count. Countable financial assets
include such items as bank accounts, stocks & bonds, life insurance of a certain
value, and the like. Items such as your home, one car, and personal possessions are not
part of the asset count.
Enrollment for the Qualifying Individual program may be capped, depending on how many
persons enroll, so it is advisable to apply sooner rather than later. Persons already
enrolled this year will be given priority to re-enroll (ahead of new applicants) for the
year to come.
Application for coverage is made with the state Division of Medical Assistacne. For
information and assistance, contact your local Council on Aging, and ask to speak with a
representative from the SHINE program or call Elder Services and speak to Margie Ware, the
SHINE coordinator.
Linda Lissack is paralegal/advocate of the Mass. Medicare Advocacy Project. The Mass.
Medicare Advocacy Project is a state-wide legal services project, working to assist
elderly and disabled persons in maximizing medicare coverage of health care services. MAP
offers free legal advice and representation to persons who may have been incorrectly
denied Medicare coverage for necessary medical treatment. Contact them at Western Mass.
Legal Services, 127 State St., Springfield, MA 01103, 413-781-7814, or 1-800-639-1109.