49 Blackburn Center, Gloucester MA | 100 Cummings Ctr, Ste 106H, Beverly, MA
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Medicare Savings Programs / MassHealth Buy-In

Feb 15, 2020

Working in an aging services agency, I hear stories quite often of seniors who are having to make horrible choices—should they buy their medication or groceries? Should they pay their utility bill or their Medicare premium?  Too many people simply do not have adequate assets and/or income to cover these necessary expenses. Recently, I learned about a Massachusetts program that has been expanded in 2020.  The new income and asset guidelines for the MassHealth Buy-In program will help an estimated 40,000 additional individuals with their medical expenses.

Massachusetts residents on Medicare with limited income and assets may qualify for help paying their Medicare costs. MassHealth offers Medicare Savings Programs, also known as MassHealth Buy-In to help with these costs.

A Medicare Savings Program can help pay some out-of-pocket costs, including:

  • Monthly Medicare Part B premium
  • Prescription drug costs through the Part D Extra Help program
  • In certain cases, out-of-pocket Part A and Part B costs, such as coinsurance and deductibles
  • In certain cases, Part A premium

Starting January 1, 2020, income eligibility has been expanded for the MassHealth Buy-In program from 135% Federal Poverty Level to 165% and the asset limit was doubled. The expansion is expected to significantly reduce Medicare costs for approximately 40,000 individuals, providing thousands of dollars in out-of-pocket savings on average per year to promote economic security.

How much a person might save through the MassHealth Buy-In program depends on a number of factors, but if they meet income and asset limits, the savings could be significant. For example, a 79 year-old person with $17,000 in Social Security income could see a drop in annual out-of-pocket health care costs from approximately $6,000 per year to about $600.

Types of income that are used in deciding if you qualify for the MassHealth Buy-In program are: Social Security, pensions, federal veterans’ benefits, annuities or trusts, dividends and/or interest, income from a job, rental income and income from other sources. Types of assets that are used include: savings and checking accounts, a second car, certificates of deposit, stocks, bonds and mutual funds. Primary home ownership is generally not counted as an asset in determining eligibility for the MassHealth Buy-In program.

When an application for MassHealth Buy-In program is approved, the coverage begins on the first day of the calendar month after MassHealth determines the eligibility.

If a person is already enrolled in or applies and qualifies for MassHealth Standard, their coverage could include the benefits of MassHealth Buy-In. MassHealth Customer Service can provide more information about individual coverage. Because of the income and asset level changes, if a person has applied for MassHealth Buy-In prior to January 1, 2020, and was denied, they should review the new income and asset limits, and consider reapplying now.

MassHealth Buy-In applications can be requested by calling the MassHealth Customer Service Center by phone at 1-800-841-2900, or TTY at 1-800-497-4648, or you can download one at https://www.mass.gov/service-details/help-paying-medicare-costs.

For more information about Medicare, Massachusetts offers a free service called SHINE (Serving the Healthcare Needs of Everyone). SHINE provides health insurance information, counseling, and assistance to Massachusetts residents with Medicare and their caregivers.

SeniorCare hosts free SHINE counseling sessions for Medicare members and prospective members. SHINE Counselors offer free, unbiased information about the many choices to be made when enrolling or re-enrolling in Medicare. Anyone interested in reserving a 45-minute session should contact 978-281-1750 (TTY 978-282-1836). All counseling sessions are held at SeniorCare’s offices at 49 Blackburn Center in Gloucester, MA.  SHINE counseling is also available at most Councils on Aging and many local hospitals.  More information about SHINE can be found at https://shinema.org.