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Medicare Savings Programs

Medicare provides low-cost medical insurance coverage and has multiple parts to the program.

  • For those who qualify, Medicare Part A (hospital insurance) is free.
  • The cost of Medicare Part B (medical insurance) premiums is tied to your annual income, and, if you're new to Medicare or don't have your Medicare Part B premiums taken from your Social Security checks, generally costs $104.90 per month in 2015 for single taxpayers with an income of $85,000 or less ($170,000 if married and filing a joint tax return).

For those with low incomes, however, carving out additional money from an already tight monthly budget can be next to impossible. Fortunately, there are four Medicare Savings Programs to help you pay for healthcare coverage if you have lower income and asset levels. These four programs are:

Certain income and asset limits must be met to qualify for these programs. Note that the income limits listed below are for those with unearned incomes (like Social Security Disability Insurance). People with earned incomes (working) are allowed higher income limits when qualifying for Medicaid or Medicare Savings Programs. Contact your county Department of Social Services for additional information.

Program Comparison

To help you better understand what each program offers and figure out if you qualify for any of them, the following comparison chart is provided.

 Medicare Savings Programs  Single Monthly Income Limit  Couples Monthly Income Limit  Helps Pay Your…
 QMB $993 $1,331 Part A and Part B premiums and other cost-sharing (like deductibles, co-insurance and co-payments)
 SLMB $1,187 $1,593 Part B premiums only
 QI $1,333 $1,790 Part B premiums only
 QDWI $3,975 $5,329 Part A premiums only

The asset limits are the same for all programs as noted in the individual charts. Six months after receipt, retroactive Social Security Disability Insurance or SSI benefits are excluded.

Note: Add $20 to each of the monthly amounts listed above to determine the actual income limit because applicants are allowed a $20 disregard from any income before it’s measured against the federal poverty levels. Couples only get one $20 disregard.

Qualified Medicare Beneficiary (QMB) Program

The Qualified Medicare Beneficiary (QMB) Program helps people whose assets are not low enough in order to qualify for Medicaid, a state assistance program.

QMB Program 2014 
Income and Asset Limit
   Monthly Income Limit  Resource Limit*
 Single $993 $7,160
 Married Couples $1,331 $10,750
* Resources include money in a checking or savings account, stocks and bonds. Resources generally don’t include your home, car, burial plot, up to $1,500 for burial expenses, furniture and other household items. Also, many states figure your income and resources differently, so it’s a good idea to check your state even if you think you exceed these limits.

 

QMB pays for the following:

  • Medicare Part A premium for those who do not receive it automatically because they are not eligible for Social Security.
  • Standard Medicare Part B premium.
  • Deductibles for both Part A and Part B.
  • Co-insurance under both Parts A and B (in other words, the deductibles and amounts not covered under Parts A and B).

 

Specified Low-income Medicare Beneficiary (SLMB) Program

 

The Specified Low-income Medicare Beneficiary (SLMB) Program helps low-income persons by paying their Medicare Part B premiums that would otherwise be deducted from their Social Security checks.

 SLMB Program 2014
Income and Asset Limits
   Monthly Income Limit  Resource Limit*
 Single $1,187 $7,160
 Married Couples $1,593 $10,750
* Resources include money in a checking or savings account, stocks and bonds. Resources generally don’t include your home, car, burial plot, up to $1,500 for burial expenses, furniture and other household items. Also, many states figure your income and resources differently, so it’s a good idea to check your state even if you think you exceed these limits.

 

 

Qualified Individual (QI) Program

 

The Qualified Individual (QI) Program helps low-income people by paying their Part B premiums.

 QI Program 2014 
Income and Asset Limits
   Monthly Income Limit  Resource Limit*
 Single $1,353 $7,160
 Married Couples $1,790 $10,750
* Resources include money in a checking or savings account, stocks and bonds. Resources generally don’t include your home, car, burial plot, up to $1,500 for burial expenses, furniture and other household items. Also, many states figure your income and resources differently, so it’s a good idea to check your state even if you think you exceed these limits.

 

 

Qualified Disabled Working Individual (QDWI) Program

 

The Qualified Disabled Working Individual (QDWI) Program is available to you if you had Social Security Disability Insurance and Medicare, but lost your Social Security benefits and free Medicare Part A because you returned to work and your earnings exceed the limit allowed.

QDWI pays the Part A premium which was previously available to you for free while on Social Security.

 QDWI Program 2014
Income and Asset Limits
   Monthly Income Limit  Resource Limit*
 Single $3,975 $4,000
 Married Couples $5,329 $6,000
* Resources include money in a checking or savings account, stocks and bonds. Resources generally don’t include your home, car, burial plot, up to $1,500 for burial expenses, furniture and other household items. Also, many states figure your income and resources differently, so it’s a good idea to check your state even if you think you exceed these limits.

How to Apply for Medicare Savings Programs

To take part in any of the Medicare Savings Programs, you must also be eligible to receive Medicare Parts A and B. If you think you qualify for any of these Medicare Savings Programs, you should apply to get help with your Medicare costs.

If you are already on Medicare, contact your county Department of Social Services to apply for QMB, SLMB, QI or QDWI benefits. Medicare Savings Program applications are processed through the county offices.

If you are not on Medicare yet, apply at any Social Security office, and declare in writing that you are applying for conditional Medicare under one of the Medicare Savings Programs. Once you become eligible for Medicare, follow up with your county's Department of Social Services to apply for any of the Medicare Savings programs.

Find your state and then the applicable county's contact information below.