Example 1:
Sue is 71. She has Medicare
but is low-income, making only $750/mo, and has little savings. She
is relatively healthy as long as she sees her doctor monthly to control
her heart and sugar (for which the doc charges the (fictional) Medicare
rate of $100/visit) and usually has one short hospitalization per year,
of approximately 3 days. Her blood pressure and diabetes meds run
her $150/mo.
Sue would
likely be eligible for the following programs that pay for healthcare costs:
1) Full Medicaid - which
would:
-
Pay Sue's Medicare Part A deductible for the one hospitalization she usually
has each year, saving her $840.
-
Pay Sue's Medicare Part A coinsurance for the three days she is hospitalized,
saving her $210/day or $630 total.
-
Pay Sue's Medicare Part B premium, saving her $58.70/month or $704.40/year.
-
Pay Sue's Medicare Part B annual deductible, saving her $100/year.
-
Pay Sue's Medicare Part B coinsurance on her monthly doctor's visit, amounting
to 20% or $20 per visit or $240/year.
-
Pay for Sue's heart and diabetes medications, saving her $150/mo or $1800/year.
2) Food Stamps - which
would
-
Provide Sue with up to $139/mo (or $1668/year) towards the cost of food.
3) LIHEAP - which would:
-
Provide Sue a grant of a minimum of $50/mo ($600/year) to cover heating
costs.
-
Might provide Sue a weatherization grants of $2568.
-
Might provide Sue additional crisis funds up to $300 if needed to pay for
broken heating equipment, lack of fuel, danger of or termination of utility
service.
4) Property Tax or Rent
Rebate - which would:
-
Provide Sue up to $500/year back on rent or property taxes she has paid.
Summary of possible annual
savings from Example 1:
$840 - Medicare Pt A Hosp. Deductible
$630 - Medicare Pt. A Hosp Coinsurance
$704.40 - Medicare Pt. B monthly
premium
$100 - Medicare Pt. B annual
Deductible
$240 - Medicare Pt. B doctor's
visit co-pays
$1800 - Rx Drug Savings
$1668 - Food Stamps savings
$600 - Energy Assistance savings
$500 - Rent/Property Tax Rebate
_______
$7,082.40
Example 2:
Dan is 67. He is married.
He has Medicare but he and his wife make only $1200/mo and have only $3500
saved up. He takes 5 prescription drugs/mo that cost about $180/mo
and cannot afford a Medigap policy or Medicare HMO to cover the things
Medicare doesn't cover. He would likely be eligible for:
1) Medicaid - Medicare
Savings Program - which would:
-
Provide Dan with state payment of Medicare Part B premiums, a savings of
$58.70/mo. or $704.40/yr.
2) PACE - which would:
-
Provide Dan with coverage of Rx Drugs with only $30/mo in co-pays instead
of $180/mo, a savings of $150/mo or $1800/yr.
3) Food Stamps - which
would:
-
Provide Dan and his wife up to $139/mo in savings on food costs.
4) LIHEAP - which would:
-
Provide Dan a grant of a minimum of $50/mo ($600/year) to cover heating
costs.
-
Might provide Dan a weatherization grants of $2568.
-
Might provide Dan additional crisis funds up to $300 if needed to pay for
broken heating equipment, lack of fuel, danger of or termination of utility
service.
5) Rent/Property Tax Rebate which
would:
-
Provide Dan a savings of up to $500/yr.
Summary of possible annual
savings from Example 2:
$704.40 - Medicare Pt. B monthly
premium
$1800 - Rx Drug Savings
$1668 - Food Stamps savings
$600 - Energy Assistance savings
$500 - Rent/Property Tax Rebate
_______
$5272.40