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Wednesday, November 21, 2018



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Council on Aging offers individuals help with Medicare questions and plans

Council on Aging offers individuals help with Medicare questions and plans

Lafourche Council on Aging (LCOA) has announced that they have assisted 402 clients in obtaining the best prescription drug plans with a total savings of over $650,000.

The Council encourages clients who are on Medicare to check their plans each year from October 15 to December 7th. And although this year’s enrollment period has ended, extra help applications can be done anytime, assisting clients with their premiums.

“This is the reason we stress so much that everyone should check their plans,” said LCOA executive director Charlene Rodriguez. “Not everyone should be in the same plan.”

What plan is best for an individual depends on the medications they are taking. Each year plans change, premiums change, formularies change.

“This year the plan you are on may cover all your medications, next year they may opt not to cover some,” stated Rodriguez. “If you opt to stay in the same plan and they don't cover some of your medications, you are stuck in that plan till the next year unless you are getting extra help.”

Everyone must apply for a prescription drug plan once they enroll in Medicare. If they do not have creditable coverage (which means they have an insurance that covers medication) they will be penalized 1% for each month they could have enrolled but didn't.

“We do have programs that assist low income people with help paying for their prescription drug plans,” said Rodriguez.

To qualify for extra help you must meet income and asset guidelines and must have Medicare Part A, Medicare Part B or both. This extra help is available through both Part B stand alone programs as well as Medicare Advantage Programs that include drug coverage. If you receive SSI (Supplemental Security Income) or Medicaid, you automatically qualify for the extra help and it is not necessary to apply.

Otherwise individuals must meet the income and asset guidelines below:

Individual monthly income limit: Not more that $1,505; Asset limit: Not more than $13,640;

Couples monthly income limit: $2,023; Asset limit not more than $27,250.

Medicare Savings Program

The Medicare Savings Program provides assistance with Medicare premiums, deductibles and coinsurance. The program consists of three savings categories which an individual may qualify for if they meet certain guidelines.

Qualified Medicare Beneficiary (QMB)

Individual monthly income limit: Not more than $1010; Asset limit: Not more than $7,280;

Couples monthly income limit: Not more than $1,355; Asset limit: Not more than $10,930.

What QMB pays:

- Part A premium

- Part A & B deductibles

- Full extra help for Part D plans

- Part B premium

- 20% co-insurance

- Cost share for Medicare Advantage Plan

Special Low Income Medicare Beneficiary (SLMB)

Individual monthly income limit: Not more than $1,208; Asset limit: $7,280;

Couples monthly income limit: $1,622; Asset limit: Not more than $10,930.

SLMB pays for Part B monthly premium and full extra help for Part D.

Qualified Individual (QI)

Individual monthly income limit: Not more than $1,357; Asset limit: Not more than $7,280;

Couples monthly income limit: Not more than $1,823; Asset limit: Not more than $10,930.

QI Pays for Part B monthly premium and full extra help for Part D.

If anyone needs help in applying for any services please contact Chantell Vedros or Charlene Rodriguez at (985) 532-0457.