Medicare Saving Programs

If you are a senior with limited income or limited resources and you think you won’t be able to pay for Medicare when you apply, or you already have Medicare but you cannot pay part of it anymore, there could be a solution for you. Besides health benefits of Original Medicare, Medicare Part C and D, and Medigap, Medicare also has other programs that support the elderly. In this article, we will cover the most important information about Medicare Saving Programs.

What are Medicare Saving Programs?

     Medicare Saving Programs are programs that are Medicaid-administered to help people pay the costs of their plans. Depending on the plan you join, they could pay for your premiums, deductibles, coinsurance and/or copayments.

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There are four Medicare Saving Programs available: Qualified Medicare Beneficiary (QMB) Program, Specified Low-Income Medicare Beneficiary (SLMB) Program, Qualifying Individual (QI) Program and Qualified Disabled and Working Individuals (QDWI) Program.

Being eligible for one of the plans will depend on your income and resources, because each of them has a limit on the income and resources you can have. However, we recommend you to consult Medicare in your state because you may qualify for one of the programs even if your income is slightly higher than the limit of the program. Also, the limits in Alaska and Hawaii are slightly higher than the ones we will present below, so consult Medicare in your state to see if you are eligible.

       Qualified Medicare Beneficiary (QMB) Program

      To qualify for QMB, your individual monthly income must be below $1,032, and if you are married, the monthly income of the couple must be below $1,392. The individual resource limit is $7,560 and if you are married, the couple’s resource limit is $11,340.

QMB helps paying for your Medicare Part A and Medicare Part B premiums, and your deductibles, coinsurance, and copayments.

When you get QMB, if you get a service that is covered by Medicare, Medicare providers are not allowed to bill you deductibles, coinsurance, and copayments, except for prescription drugs. Because of this, it is important to carry with you your Medicare card and your QMB card. In case you have Medicare Advantage Plan, QMB will pay for your plan’s cost sharing.

Take into consideration that you can have both QMB and Medicaid, but you cannot have a Medigap policy.

     Specified Low-Income Medicare Beneficiary (SLMB) Program

     To qualify for SLMB, your individual monthly income must be below $1,234, and if you are married, the monthly income of the couple must be below $1,666.The individual resource limit is $7,560 and if you are married, the couple’s resource limit is $11,340.

SLMB will only pay for your Part B premiums. You can have both SLMB and Medicaid.

    Qualifying Individual (QI) Program

To qualify for QI, your individual monthly income must be below $1,386, and if you are married, the monthly income of the couple must be below $1,872.The individual resource limit is $7,560 and if you are married, the couple’s resource limit is $11,340.

QI will only pay for your Part B premiums and will provide three months retroactive Part B premium reimbursement from the month of application.

To get QI, you must apply every year and priority is given to people who got QI benefits the previous year. If you qualify for Medicaid, you cannot have QI.

     Qualified Disabled and Working Individuals (QDWI) Program

    To qualify for QDWI, any of the following must apply to you: you’re a working disabled person under 65; you lost your premium-free Part A when you went back to work; you aren’t getting medical assistance from your state and/or you meet the income and resource limits required by your state

Additionally, your individual monthly income must be below $4,132, and if you are married, the monthly income of the couple must be below $5,572.The individual resource limit is $4,000 and if you are married, the couple’s resource limit is $6,000.