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The Medicare Buy-In Program, better known as the Medicare Savings Program, will help to pay Medicare premiums. If a beneficiary qualifies, the state Medicaid will pay Medicare premiums for Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). In some cases, Medicare Buy-In will pay deductibles, coinsurance and copayment if a recipient meets certain conditions.
There are four Medicare Saving Programs:
- Qualified Medicare Beneficiary (QMB)
- Specified Low-Income Medicare Beneficiary (SLMB)
- Qualifying Individual (QI)
- Qualified Disabled & Working Individuals (QDWI)
If a beneficiary qualifies for QMB, SLMB, or QI, they automatically qualify for extra help paying the costs of Medicare prescription drug coverage.
The Social Security Administration (SSA) determines if a beneficiary should be enrolled in Medicare Part A. Everyone who is 65 years old and has lived in the United States for five years qualifies for Medicare Part B. Beneficiaries must enroll in Medicare at the age of 65 in order to avoid a 10% penalty on their premiums. If a beneficiary qualifies for both Medicare and Medicaid they must enroll in Medicare at the age of 65 as Medicaid will reject all Medicaid claims at this age. Beneficiaries may enroll through the SSA.
The Michigan Department of Health and Human Services (MDHHS) determines Medicaid eligibility by computing a recipient's household income and budget. When a recipient is found to be eligible for Medicaid and Medicare the Medicare Buy-In Unit will pay the Medicare premiums. Beneficiaries may apply for this service through MDHHS.
Websites that provide more information:
Michigan Department of Health and Human Services (MDHHS): http://www.michigan.gov/mdhhs/
Centers for Medicare and Medicaid Services (CMS): http://www.cms.gov/
Social Security Administration (SSA): http://www.ssa.gov/
Michigan Medicare/Medicaid Assistance Program (MMAP): http://www.mmapinc.org/
Official U.S. Government Site for Medicare: http://www.medicare.gov/
MDHHS Third Party Liability Medicare Buy-In Unit Contact Information:
Michigan Department of Health and Human Services
Medicare Buy-In Unit
P.O. Box 30435
Lansing, MI 48909
For beneficiaries with Medicare Buy-In questions please contact the Beneficiary Hot Line:
For providers with Medicare Buy-In questions please contact the Provider Service Help Line:
If you need additional information you can refer to the Provider Manual:
Coordination of Benefits, Section 2.6 A-F
General Information Chapter, Section 11.1