Most individuals, when they reach age 65, sign up for Medicare. For most participants, Medicare Part A (hospital insurance) is free. For other parts that are needed, such as Part B (outpatient medical insurance), Medigap (supplemental insurance), and Part D (prescription coverage), the costs can be high and, for many low-income families, difficult to fund.
Fortunately, Medicare has developed four different kinds of savings programs through individual states’ Medicaid offices that provide Medicare savings for different types of Medicare expenses for families of limited income and resources. Following are four savings programs, with the associated benefits and eligibility requirements.
Qualified Medicare Beneficiary Program (QMB)
- Individual monthly income limit (2022): $1,153
- Married couple income limit (2022): $1,546
Limits are slightly higher in Alaska and Hawaii.
If you have income from working, you may qualify for benefits even if your income is higher than the prior limits.
- Individual resource limit (2022): $8,400
- Married couple resource limit (2022): $12,600
Countable resources include checking or savings account, stocks and bonds. They do not include your home, one car, a burial plot or up to $150 in burial costs if put aside already.
Benefits of QMB: It can cover premiums of Part A and Part B; deductibles, co-insurance, co-payments for services and items Medicare covers, except for outpatient drugs
Specified Low-income Medicare Beneficary Program (SLMB)
- Individual monthly income limit (2022): $1,379
- Married couple monthly income (2022): $1,851
- Individual resource limit: $8,400
- Married couple resource limit: $12,600
Benefits of SLMB: This state program subsidizes Part B premiums for individuals/families that have Part A and have limited income and resources
Qualified Individual Program (QI)
- Individual monthly income (2022): $1,549
- Married couple monthly income (2022): $2,080
- Individual resource limit: $8,400
- Married couple resource limit: $12,600
Benefits of QI: This state program subsidizes Part B premium for those who have Part A.
Restrictions: First come first served, with priority for those who qualified the previous year (you must apply each year). You are not eligible if you qualify for Medicaid.
Qualified Disabled and Working Individual Program (QDWI)
- Individual monthly income (2022): $4,615
- Married couple monthly income (2022): $6,189
- Individual resource limit: $4,000
- Married couple resource limit: $6,000
Benefits of QDWI: This program subsidizes Part A premiums. You may qualify if you have a disabling impairment but continue to work and are not otherwise eligible for Medicaid.
Drug coverage: If you qualify for QMB, SLMB or PI, you automatically qualify to obtain additional financial assistance that subsidizes drug coverage associated with Medicare. The amounts of the subsidy can increase each year; you should apply each year.
Eligibility: You are eligible for any of the four categories of Medicare savings if can answer all of the following three questions positively.
Are you eligible for Part A, or do you already have it? Is your income at, or below the specified income levels? Are the limits of your resources consistent with the specific limits specified?
In order for you qualify for any of the four Medicare savings plans, you have to contact your state’s Medicaid office and fill out the required forms. For more information, go to: https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs.
(Elliot Raphaelson welcomes your questions and comments at [email protected].)
©2022 Elliot Raphaelson. Distributed by Tribune Content Agency, LLC.
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