If you are enrolled in Medicare and your monthly income is $1,649* or less ($2,211* if you are married - or up to $2,523* if only one spouse enrolls in MSP), you are now eligible for the Medicare Savings Program. This benefit is sometimes called "MSP" or the "Medicare Buy-In."

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*NOTE: If you are working, your income can be even higher!

When you sign up for the Medicare Savings Program:

• Your Medicare Part B premium ($93.50 per month) will be paid
• Your ONLY Medicare Part D (drug) expense will be a maximum of $2.68 for brand name drugs covered by your prescription drug plan. There is no cost for generic drugs!
  
  Be sure to show the pharmacist your Low Cost Drugs for the Elderly and Disabled (DEL) card to get the lowest costs. When you sign up for the Medicare Savings Program, you also get the Low Cost Drugs for the Elderly and Disabled (DEL) benefit.
  
  In order to have the full amount of your Part D monthly premium paid, you need to be enrolled in a "basic" plan with a premium that is equal to or less than the federal "benchmark." Call the DHHS Pharmacy Help Desk for more information: 1-866-796-2463 (TTY 1-800-423-4331).

Some people will have almost ALL Medicare costs paid for!

If your monthly income is $1,351 or less ($1,811 for a married couple - or up to $2,523 if only one spouse enrolls in the Medicare Savings Program), your ONLY Medicare costs (for Parts A, B, and D) will be a $1.55 copay for brand name drugs!

Background

The Medicare Savings Program (MSP) is run by the MaineCare program at the Department of Health and Human Services (DHHS). As of April 1, 2007, DHHS has new eligibility rules for MSP. Now nearly everyone who is enrolled in Medicare and eligible for the Low Cost Drugs for the Elderly and Disabled(DEL) program is also eligible for the MSP.

If your monthly income is at or below $1,649 ($2,211 for a married couple - or up to $2,523 if only one spouse enrolls in MSP) you are eligible for both DEL and MSP. This income level is 194% of the federal poverty level in 2007. If you are working, your income can be even higher.

There is no asset test for either DEL or MSP. And there is no estate recovery for DEL and MSP, unless you are also enrolled in full-benefit MaineCare.

How do I apply for the Medicare Savings Program (MSP)?

To apply for MSP, you can:

• Call or go in to your local DHHS office
• Call DHHS toll-free at 1-877-543-7669

If you are eligible for MSP, DHHS will also enroll you in DEL.

What if I was already enrolled in DEL in April?

If you have Medicare and were enrolled in DEL on April 1, 2007, DHHS automatically enrolled you in MSP. You should have received a letter from DHHS in early April explaining this change.

Why should I enroll in the Medicare Savings Program (MSP)?

With MSP, you will no longer need to pay the cost of your Part B premium ($93.50 per month) but it may take a few months before your Social Security check increases because the Part B premium cost is no longer being taken out of your check. You will get a check from the Social Security Administration to repay you for any Part B premium costs that were taken out of your Social Security check (starting with your April check). You will get this check automatically.

For drugs that are covered by your Medicare Part D prescription drug plan, you will have:

• No copay for generic drugs and
• Only a small copay for brand name drugs that are covered by your Medicare Part D prescription drug plan ($1.55 or $2.68, depending on your income)

If you were enrolled in DEL on April 1, 2007 and paid more than this for drugs you have purchased since that date, you can get a reimbursement from your prescription drug plan. To be reimbursed you have to:

1. Save receipts from the drugstore - both the cash register receipt and the pharmacy receipt;
2. Fill out a reimbursement form (DHHS sent this form to you);
3. Send the form and receipts to your Medicare Prescription Drug Plan.

It is important to keep a copy of everything sent in and mark the date it was mailed.

What other benefits will I get from my enrollment in MSP?

If you are enrolled in MSP, you can change your Part D prescription drug plan as often as once a month. If you need a new drug that isn�t covered by your plan, or if your plan stops covering drugs you need, you will now be able to change to another plan any time during the year. The DHHS Pharmacy Helpline can help you select a new plan that will work best for you.

If your monthly income is at or below $1,351 ($1,811 for a married couple - or up to $2,523 if only one spouse enrolls in the Medicare Savings Program) you are eligible for additional MSP benefits. If you are working, your income can be even higher. MSP will pay for nearly all your other Medicare plan costs, including:

• the Medicare Part A premium (if you have a Part A premium - most people do not), deductible, and copays/coinsurance;
• the Medicare Part B premium, deductible, and copays/coinsurance; and
• the Medicare Part D premium, deductible, coinsurance, coverage gap (doughnut hole).

Your only Medicare cost will be a $1.55 copay for brand name drugs covered by your prescription drug plan (generics have no copay). People with this benefit are enrolled in the QMB ("Quimby") portion of the MSP.

What if my pharmacist tells me I have to pay a higher copayment?

Don't forget that:

• You may need to show your pharmacist your DEL card to get the lowest copay
• These copays are only for drugs that are covered by your Part D prescription drug plan

If your pharmacist says that you need to pay a higher copay, mention that you should get the "state wrap." If you are still asked to pay more than the MSP copay, call the DHHS Pharmacy Help Desk (number below).

For more information:

DHHS Pharmacy Help Desk toll-free at 1-866-796-2463 (TTY 1-800-423-4331)

DHHS statewide toll-free number: 1-877-543-7669

Maine Equal Justice Partners at 1-866-626-7059