Medicare Savings Program (MassHealth Buy-In) Update
The Medicare Savings Program (MSP), also known as the MassHealth Buy-In Program, can help older Massachusetts residents and residents living with a disability save on their Medicare coverage. The MassHealth Buy-In Program includes:
Qualified Medicare Beneficiary (QMB) program,
Buy-In Specified Low-Income Medicare Beneficiary (SLMB), and
Qualifying Individuals (QI) program.
On January 1, 2020, eligibility for these programs expanded. The tables below show the current income and asset limits.
Buy-In Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individuals (QI) Expansion
Income is at or below
Assets/resources at or below
$1,755 per month
A married couple living together
$2,371 per month
Correcting a System Error
Due to a system error in calculating eligibility, some members who should have been approved for the Qualified Medicare Beneficiary (QMB) program were not. The error has been corrected. As a result, members erroneously enrolled as SLMB or QI members who should have been approved for QMB will receive a notice and be upgraded as follows:
Will be upgraded to QMB with a retroactive start date...
Were receiving SLMB or QI before January 1, 2020
Of January 1, 2020
Became eligible for QMB but were receiving SLMB or QI on or after January 1, 2020
Based on the eligibility start date on or after January 1, 2020 of their original MassHealth Buy-In Program
How to Apply
Use the Medicare Savings (Buy-In) Programs Application if only applying for these 3 programs and not for other MassHealth programs.
New applicants who apply through the full MassHealth application and are not eligible for a MassHealth benefit will be approved for the appropriate Buy-In benefit if they are eligible based on the current financial guidelines.
In this case, the members' health-care provider must pay the member back for any money collected from a member erroneously enrolled as SLMB or QI for MassHealth-covered services and bill MassHealth for the service. The provider must accept the MassHealth payment as payment in full.
Both fully enrolled MassHealth providers and QMB- only providers could potentially rebill MassHealth for deductibles, coinsurance, or copays covered under QMB that may have been billed directly to members who were erroneously enrolled in SLMB.
MassHealth providers should refer to the Qualified Medicare Beneficiaries regulation at 130 CMR 519.010: MassHealth Senior Buy-In and in 130 CMR 505.007: MassHealth Senior Buy-In and Buy-In and certain MassHealth Standard members who are eligible for QMB benefits described in 130 CMR 519.002(A)(4)(c) and 130 CMR 505.002(O) for more information on billing instructions.
Factsheets about the MSP program and the expansion are printable and are available in English, Spanish, and Chinese.
New: MassHealth No Accepts ARD I and PSI Form Completion VERBALLY
Effective 06/29/2020, MassHealth applicants or members may complete the ARD I (Authorized Representative Designee) and PSI (Permission to Share Information) forms verbally on a recorded phone line with MassHealth Customer Service.
IMPORTANT: Both the MassHealth applicant or member and Assister or designee must be on the phone at the time of request.
The ability to provide a Verbal ARD I will continue beyond the COVID-19 national emergency period.
The ability to provide a Verbal PSI will be reviewed when the COVID-19 national emergency period ends.
Verbal requests for all ARD II or ARD III designations will not be completed over the phone. Continue to complete and submit by mail or fax requests for ARD II and ARD III. The ARD form is available in English and Spanish.