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What is the Medicare Savings Program?

Medicare Savings Program

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If you have limited resources and income and cannot afford Medicare, you do have the opportunity to qualify for a Medicare Savings Program. To be eligible for a Medicare Savings Program, you must first be eligible for Medicare Part A and meet the income and asset guidelines, which vary by state. Even if your income assets are above the guidelines, you can still apply. 

Depending on which one of the four programs you qualify for, you can receive coverage for premiums or other out-of-pocket costs. 

The four programs Medicare Savings Programs are:

Qualified Medicare Beneficiary (QMB)

The Qualified Medicare Beneficiary (QMB) Program will help pay for Medicare Part A and Part B premiums, as well as any deductibles, coinsurance, or copayments you will have. To determine your eligibility, the program will use the low-income subsidy asset test. 

The QMB limits you must meet are:

Income Limits:

  • Individual monthly income limit: $1,084
  • Married couple monthly income limit: $1,457

Resource Limits:

  • Individual resource limit: $7,860
  • Married couple resource limit: $11,800

You can also automatically qualify for Extra Help if you qualify for the QMB Program. Extra Help can be used to cover prescription drug program costs, including premiums, deductibles, or coinsurance. 

Specified Low-income Medicare Beneficiary (SLMB)

 The Specified Low-income Medicare Beneficiary (SLMB) Program will only help pay for the Medicare Part B premium. To be eligible, you are required to meet income and asset requirements.

The SLMB limits you must meet are:

Income Limits:

  • Individual monthly income limit: $1,296
  • Married couple monthly income limit: $1,744

Resource Limits:

  • Individual resource limit: $7,860
  • Married couple resource limit: $11,800

You can also automatically qualify for Extra Help if you qualify for the SLMB Program.

Qualifying Individual (QI)

The Qualifying Individual (QI) Program will only help pay for the Medicare Part B premium. The QI limits you must meet are:

Income Limits:

  • Individual monthly income limit: $1,456
  • Married couple monthly income limit: $1,960

Resource Limits:

  • Individual resource limit: $7,860
  • Married couple resource limit: $11,800

The QI program is quite different from the QMB and SLMB Programs. For the QI Program, you will need to apply every year to receive QI benefits, but the applications are on a first-come, first-served basis, especially for those who received QI benefits during the previous year. Also, if you qualify for Medicaid, you will not be able to receive QI benefits.

However, just like the QMB and SLMB Programs, you can automatically qualify for Extra Help if you qualify for the QI Program.

Qualified Disabled Working Individual (QDWI)

The Qualified Disabled Working Individual (QDWI) Program will only help pay for the Medicare Part A premium. To qualify for the QDWI Program, at least one of these factors should apply to you: 

  • Under the age of 65
  • Working but have a disabling impairment
  • Lost your premium-free Part A when you went back to work
  • Have limited assets and income
  • Not eligible for Medicaid

The QDWI limits you must meet are:

Income Limits:

  • Individual monthly income limit: $4,339
  • Married couple monthly income limit: $5,833

Resource Limits:

  • Individual resource limit: $4,000
  • Married couple resource limit: $6,000

How can I apply for a Medicare Savings Program?

To apply, you will need to call your state’s Medicaid office as state Medicaid programs manage the Medicare Savings Programs.

If you are eligible for Medicare, reach out to us for a free consultation today. We can help you compare the costs of plans, estimate your savings, and help you through the enrollment process! Our experienced brokers are focused on educating you first so you can make an informed decision on your healthcare. Give us a call today at 877-877-5505.

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