Senior Resources

Medicare / Health Insurance Programs

Below are a list of Medicare / Health Insurance programs along with requirements.

How / When to Apply for Medicare

Visit the following websites for detailed information on how and when to apply for Medicare based on your own individual situation.

Medicare Savings Program (MSP) and Medicaid

You can get help from your state paying your Medicare premiums. There are different kinds of Medicare Savings Programs:

  • Qualifing Individual (QI)
    • Pays for your Part B premium
    • May receive up to 3 months retroactive reimbursement for Part B premiums (Note: only for premiums paid up to 3 months before your MSP effective date, and within the same year of that effective date).
    • Individuals cannot have both QI & Medicaid
    • Monthly Income Limits: $2,280 (individuals) $3,077 (couples) No asset limit
  • Qualified Medicare Beneficiary Program (QMB)
    • Pays for Medicare premiums
    • Providers are prohibited from charging you for Medicare cost-sharing (deductibles, coinsurance and co-payments). This means you should not be billed for any Medicare-covered services you receive from Original Medicare providers or providers in your Medicare Advantage Plan’s network.
    • Individuals can have both QMB and Medicaid
    • Monthly Income Limits: $1,697 (individuals) and $2,288 (couples). No asset limit
  • Medicaid
    • Health coverage for people with limited income and assets
    • For services covered by Medicare and Medicaid, Medicare will pay first and Medicaid may cover your Medicare co-insurance or copayments.
    • May cover services that Medicare does not, such as dental and/or vision
    • Monthly Income & Resource Limits:
      Individuals: $1,697 income, $28,133 resources
      Couples: $2,288 income, $37,902 resources
Elderly Pharmaceutical Insurance Coverage (EPIC)
  • NYS Program that provides co-payment assistance for Medicare Part D covered prescription drugs after any Part D deductible is met.
  • Must be 65+ and a NYS resident
  • EPIC also covers many Medicare Part D excluded drugs
  • EPIC may pay for part or all of your Medicare Part D plan premium...depends on your income.
  • Individuals can have Medicaid w/spendown only...not full Medicaid.
  • Income limits: $75,000 (individuals) $100,000 (couples)
Keep in mind:
Our staff are certified NYS Health Insurance Counselors that are available to offer unbiased assistance & guidance in navigating the Medicare system. If you feel that you might be eligible for any of these programs, please contact our office for application assistance: (518) 459-5051, ext. 2

Contact

Senior Resources Department
Located At 12 Metro Park Road Suite 103
Albany, NY 12205