Is it Worth it? Medicare Savings Program Questions Answered

Wondering if the Medicare Savings Program is worth applying for?

What is the Medicare Savings Program?

The Medicare Savings Program is a benefit that helps pay for some out-of-pocket costs such as Medicare premiums, deductibles, copayments, coinsurance, and prescription drug costs for qualifying individuals. The Medicare Savings Program does not impact your Medicare Advantage Plans or Supplements.

Who qualifies for the Medicare Savings Program?

There are four Medicare Savings Program options, each with different income and resource eligibility requirements. You may be eligible to apply with SC Thrive if you:

• Live in South Carolina;
• Meet standard income and asset guidelines; &
• Are 65 or older;
• Receive Social Security Disability benefits; OR
• Have certain disabilities or end stage renal disease.

NOTICE: Income eligibility changes every year for the Medicare Savings Program.

Why should I apply for the Medicare Savings Program? I already have a Medicare provider.

Even if you have a Medicare provider, you still may be paying for your Medicare Part B and premiums when you could save that money. Remember, the Medicare Savings Program is not Medicare coverage; it is a benefit to help you pay for Medicare costs. When looking at your Medicare coverage, look at your insurance cards to see what you have. Most people have a Medicare Advantage plan or a Medicare Supplement plan. Even though you have these plans based on the health coverage you need, you might still be paying for either plan in conjunction with your standard Medicare plan. 

How do I know if I am still paying for my Medicare Part B premiums?

Each year, you will receive a Social Security Award Letter. That letter will indicate the total amount deducted from your monthly Social Security check if you still pay for your Medicare premiums. If you need to replace your original award letter you can request a copy by calling 800-772-1213 or visiting your local SSA office.

TIP: Make sure to store your Social Security Award Letter in a safe place that is easy for you to find.

Who should I call to check on my current Medicare coverage?

You can call the customer support number listed on the back of your insurance card if you are unsure of your current Medicare coverage.

If you are working with an insurance agent, you can contact them also to see if your current plan is the best for you.

Do I have to reapply for the Medicare Savings Program? If so, when do I reapply?

Yes; you must reapply for the Medicare Savings Programs annually. When you receive your award letter for the Medicare Savings Program, it will let you know the start date of the program.

TIP: You should reapply at least one month before your start date the following year to avoid a lapse in coverage.

Do I have to include my spouse on my Medicare Savings Program application?

Yes; you must include your spouse on the application along with their income and resources for an accurate application to be processed.

What should I do after I submit a Medicare Savings Program application?

Keep up with the mail you receive from the South Carolina Department of Health and Human Services (SC DHHS) after submitting an application for MSP. They may provide an approval or denial letter or ask for additional supporting documentation. Respond promptly to all requests for supporting documentation to avoid a lapse in coverage or a denial.

Allow a 30 to 45 business day response time after your application is processed. If you have not heard or received anything from SC DHHS within that time frame, please call them at 888-549-0220 for further assistance.

How do I know if I was approved or not? Do I call SC Thrive to check on my approval?

SC Thrive assists with the application process, not the eligibility process. Any questions regarding your application status should be directed to SC DHHS at 888-549-0220.

What should I do if I was denied and don’t agree with the decision?

If you feel that there was an error on your application, or you disagree with the application outcome. You can appeal the decision with SC DHHS. Appeal information should be included in your denial letter.

How do I apply for the Medicare Savings Program?

Call the SC Thrive Contact Center at 800-726-8774 and choose option 1 to get started on an application over the phone. If you prefer to apply in person reach out to a local SC Thrive partner site such as an Area Agency on Aging. You can find your nearest Area Agency on Aging listed HERE.

Can SC Thrive connect me to other resources for Seniors?

Yes; SC Thrive has several ways that we can help seniors. We can help Seniors apply for Healthy Connections Prime, Long-Term Care benefits, & SNAP’s Elderly Simplified Application Process (ESAP). Learn about other senior resources HERE.