Medicare Savings Programs are available to individuals with low income or limited resources and help cover the cost of Medicare coverage. In addition to helping Medicare beneficiaries save on premiums, some programs also provide savings on copays, deductibles, and prescription drugs.
There are four different Medicare Savings Programs that Medicare beneficiaries can apply:
- Qualified Medicare Beneficiary (QMB) Program
- Specified Low-Income Medicare Beneficiary (SLMB) Program
- Qualifying Individual (QI) Program
- Qualified Disabled and Working Individuals (QDWI) Program
To qualify, an individual’s resources must fall below the limit set by the state government. Resources include money in checking or savings accounts, stocks, and bonds. Assets not included are homes, cars, household items and burial plots or savings for burial expenses up to $1,500.
Additionally, the individual’s monthly income is evaluated. If his or her monthly income is at or below the specified amount, they are encouraged to apply. Both resources and income limits differ for individuals who are single versus those who are married.
Note: If you qualify for QMB, SLMB, or QI, you can also enroll in Extra Help, which reduces the cost of prescription drug expenses (Medicare Part D). However, enrolling in a Medicare Savings Program is not required in order to qualify for Extra Help.
Qualified Medicare Beneficiary Program
The Qualified Medicare Beneficiary (QMB) Program helps pay for Medicare Part A and Part B premiums. It also lowers the cost of deductibles, coinsurance, and copayments.
Acceptance into the QMB program automatically qualifies you for Extra Help.
Resource limits for QMB are:
- Individual: $7, 860
- Couple: $11,800
Monthly income limits for QMB are:
- Individual: $1,084
- Couple: $1,457
Specified Low-Income Medicare Beneficiary Program
The Specified Low-Income Medicare Beneficiary (SLMB) Program assists with Medicare Part B premiums. Like the QMB program, acceptance into the SLMB also automatically qualifies you for Extra Help.
Resource limits for SLMB are:
- Individual: $7, 860
- Couple: $11,800
Monthly income limits for SLMB are:
- Individual: $1,296
- Couple: $1,744
Qualifying Individual Program
In addition to helping pay Medicare Part B premium costs, the Qualifying Individual (QI) Program also qualifies individuals for access to Extra Help. One difference, however, is that individuals must reapply for QI every year to continue receiving benefits.
Because benefits are issued on a first-come, first-serve basis, priority is generally granted to those re-applying as opposed to first-time applicants. (Note, this can vary state to state.)
Another difference is the QI program is only available to individuals who fall below the resource and income limits and do not qualify for Medicaid.
Resource limits for QI are:
- Individual: $7, 860
- Couple: $11,800
Monthly income limits for QI are:
- Individual: $1,456
- Couple: $1,960
Qualified Disabled and Working Individuals Program
The Qualified Disabled and Working Individuals (QDWI) Program helps pay for Medicare Part A premiums. Individuals eligible for this program meet the income and resource limit and are either a working disabled person under age 65, have lost premium-free Medicare Part A when they returned to work, or are not receiving other medical assistance from the state.
Resource limits for QDWI are:
- Individual: $4, 000
- Couple: $6,000
Monthly income limits for QDWI are:
- Individual: $4,339
- Couple: $5,833
Curious If You Qualify for Medicare Savings Programs?
Need extra assistance checking your eligibility for any of these four Medicare Savings Programs? Get advice from the best Medicare advisors. Medicare Choice Group can help you understand your resource and income level, explore the options that best align with your individual needs, and navigate the application process.
Connect with our team of experts online or give us a call at (855) 482-0574.
