What Are Medicare Savings Programs, and How Do I Qualify?

Medicare Savings Programs help individuals with low income or limited resources pay for their Medicare costs. Medicare beneficiaries can apply for these supportive benefits to save on premiums. Some programs even assist with deductibles, copays, and prescription drugs.

Types of Medicare Savings Programs

There are four types of Medicare Savings Programs:

  • Qualified Medicare Beneficiary (QMB) Program
  • Specified Low-Income Medicare Beneficiary (SLMB) Program
  • Qualifying Individual (QI) Program
  • Qualified Disabled and Working Individuals (QDWI) Program

If an individual qualifies for QMB, SLMB, or QI, they can also enroll in Extra Help. Extra Help regulates prescription drug expenses.

When applying for a Medicare Savings Program, an individual must specify the resources that they (and their spouse, if married) have on hand. To calculate whether resources meet or exceed the limit, state governments consider the value of money in a checking or savings account, stocks, and bonds. Assets like a single car, home, furniture, household items, and burial plots or savings for burial expenses (up to $1,500) are not included.

Alongside the resource limit, there is also a monthly income limit. If an individual’s monthly income is at or below the amount specified for a program, you are encouraged to apply. Let’s break down each type of Medicare Savings Program.

Qualified Medicare Beneficiary Program

The Qualified Medicare Beneficiary (QMB) Program helps individuals pay for Medicare Part A and Part B premiums, as well as deductibles, coinsurance, and copayments. Receiving QMB benefits automatically qualifies a beneficiary for Extra Help.

Below are the resource and monthly income limits for the QMB Program.

Medicare Savings Program: Qualified Medicare Beneficiary

Specified Low-Income Medicare Beneficiary Program

The Specified Low-Income Medicare Beneficiary (SLMB) Program assists with Medicare Part B premiums. Receiving benefits from SLMB also qualifies a beneficiary for Extra Help.

Below are the resource and monthly income limits for the SLMB Program.

Medicare Savings Program: Specified Low-Income Medicare Beneficiary

Qualifying Individual Program

The Qualifying Individual (QI) Program also helps cover the cost of Medicare Part B premiums and gives you access to Extra Help. However, with this program, individuals must reapply every year to continue receiving benefits. Benefits are distributed on a first-come, first-serve basis. Depending on the state, priority is typically given to individuals who received QI benefits in the previous year.

In addition to resource and income limits, only individuals who do not qualify for Medicaid are eligible for QI. Below are the resource and monthly income limits for the QI Program.

Medicare Savings Program: Qualifying Individual

 

Qualified Disabled and Working Individuals Program

The Qualified Disabled and Working Individuals (QDWI) Program helps pay for Medicare Part A premiums. An individual may be eligible to receive aid from this program if they:

  • Are a working disabled person under age 65
  • Lost premium-free Medicare Part A when they returned to work
  • Are not receiving other medical assistance from the state
  • Meet the income and resource limits required by the state

Below are the resource and monthly income limits for the QDWI Program.

Medicare Savings Programs: Qualified Disabled and Working Individuals

Extra Help (Prescription Drug Coverage)

As an added benefit to the QMB, SLMB, and QI Programs, Extra Help regulates the cost of prescription drugs for low-income Medicare beneficiaries. This program also helps cover premiums, deductibles, and coinsurance associated with your Medicare Part D prescription drug plan.

However, enrolling in a Medicare Savings Program is not a requirement to qualify for Extra Help. Read more about Extra Help here.

Checking Eligibility for Medicare Savings Programs

RetireMEDiQ has a dedicated team of advisors who can help you, your patients, or your loved ones apply for Medicare Savings Programs. We will explore all your options and make the process simple, all at no cost! Call us at 1-866-921-6468 or schedule a call.

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