Understanding Cost

Handbook Content

Terms and Meanings

Some terms that we use in this chapter may not be familiar. These terms and their meanings are listed below.

Individuals: People/Medicaid members.
Co-insurance: A percentage you pay for medical cost.
Liability: When you are responsible for payment or another action.
Premium: A payment you make to help cover the costs of your health care.
Qualify: Ability to have a service or coverage from a program.
Recipient Liability: The amount of money you must pay to help cover the costs of your health care.
Services: Care, treatments, testing, checkups, equipment, supplies, and other ways your health care providers help you stay healthy.
TTY: The number you can call to connect with someone when you have a hearing impairment.

Medicare Savings Programs

These programs assist with Medicare costs for members who have low income and assets.

Medicaid Saving Programs pay for:
- Medicare Part B monthly cost and yearly cost
- Medicare co-insurance costs (20% of costs for services that Medicare allows
- Monthly Medicare part A monthly cost (if not free)
Income and Assets
- Monthly income is:
  - Wages
  - Social Security
  - Pensions
  - Veteran’s benefits
  - Other sources
- Monthly income must be less than the current income eligibility level. Only a portion of your wage is counted. Some assets are not counted. Your savings and other assets must be less than the Medicare Part D Low Income Subsidy asset levels for the year you apply. Income levels change yearly. Contact the Medicaid Eligibility Call Center for the current levels.
Eligibility
- These plans are for people who have Medicare Part A and Premium-Part A
- If you are eligible for one of the Medicare Savings Programs you are automatically able to get extra help with Medicare Part D Drug Plans

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