VLA Medicare Stories
Donna + Norman: “After we pay everything, we have nothing left.”
Donna and her husband, Norman, lost eligibility for the Medicare Savings Program this year after their Social Security increased slightly due to a cost-of-living adjustment.
They’re now $13 over-income for Vermont’s Medicare Savings Program called “QI-1”, which used to pay their Medicare Part B premium. In 2024, the premium will be $174.70 per month for each of them for a total of $349.40. If their income was $13 lower, they would still qualify for the Medicare Savings Program and it would cover their Part B premium — saving them $4,192.80 every year.
The loss of the Medicare Savings Program sent them into a panic. Donna explained: “We weren’t doing that great before but at least we were surviving. Now we aren’t going to be able to survive with them taking all that money from us. No one seems to want to do anything.”
“We weren’t doing that great before but at least we were surviving. Now we aren’t going to be able to survive with them taking all that money from us. No one seems to want to do anything.”
After they lost eligibility for the Medicare Savings Program, they struggled to afford their Medigap plans. Medicare generally covers 80% of the cost of covered services. Medigap plans help cover costs that Medicare does not cover. In the past, their plans helped them pay for things that Medicare didn’t cover, like the Medicare deductibles and 20% cost-sharing. Donna’s husband is older and has a lot of health problems, so they decided to keep paying for his Medigap plan and stop paying for hers.
Without a Medigap plan, Donna wasn’t sure how she would afford to go to the doctor. In the end, she applied for patient financial assistance at her local hospital and was approved.
Donna thinks that the State of Vermont needs to raise the income level for the Medicare Savings Program. Reflecting on her day-to-day expenses like rent and groceries, she said: “After we pay everything, we have nothing left. They need to raise the level that people can make so seniors can live.”
To protect anonymity and confidentiality, some names and details in these stories have been changed.