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Medicare Savings Programs

You can get help from your state paying your Medicare premiums. In some cases, Medicare savings Programs may also pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles, coinsurance, and copayments if you meet certain conditions. 

If you qualify for QMB, SLMB, or QI programs, you automatically get Extra Help paying for Medicare drug coverage.

Four Kinds of Medicare Savings Programs

There are four programs under the Medicare Savings Programs. If you have income form working, you still may qualify for these 4 programs even if your income is higher than the income limits listed for each program. 

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  1. Qualified Medicare Beneficiary (QMB) Program

  2. Specified Low-Income Medicare Beneficiary (SLMB) Program

  3. Qualifying Individual (QI) Program

  4. Qualified Disabled and Working Individuals (QDWI) Program 

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If you qualify for the QMB program, SLMB, or QI program, you automatically qualify to get Extra Help paying for Medicare drug coverage. 

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The following amounts may increase each year. If your income and resources are slightly higher, you should still apply. 

Qualified Medicare Beneficiary (QMB)

QMB income & resource limits in 2020:

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Individual monthly income limit: $1084

Married couple monthly income limit: $1457

*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 limits lister.

Individual resource limit: $7,860

Married couple resource limit: $11,800

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Program helps pay for:

Part A premiums, Part B premiums, Deductibles, coinsurance, and copayments

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If you're eligible, the QMB program helps pay for Part A and/or Part B premiums. Medicare providers aren't allowed to bill you for services and items Medicare covers, including deductibles, coinsurance, and copayments, except outpatient prescription drugs. Pharmacists may charge you up to a limited amount (no more than 3.90 in 2020) for prescription drugs covered by Medicare Part D. 

If you get a bill for these charges, tell your provider or the debt collector that you're in the QMB Program and can't be charge for Medicare deductibles, coinsurance and copayments. If you've already made payment son a bill for services and items Medicare covers, you have the right to a refund. If you're enrolled in a Medicare Advantage Plan, you should also contact the plan to ask them to stop the charges. 

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Specified Low-Income Medicare Beneficiary (SLMB) Program

The SLMB Program is a state program that helps pay Part B premiums for people who have Part A and limited income and resources. 

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SLMB income & resource limits in 2020:

 

Individual monthly income limit: $1296

Married couple monthly income limit: $1744

*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 limits lister.

Individual resource limit: $7,860

Married couple resource limit: $11,800

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Program helps pay for:

Part B premiums only

Qualifying Individual (QI) Program

The QI Program is a state program that helps pay Part B premiums for people who have Part A and limited income and resources. You must apply every year for QI benefits. QI applicatoins are granted on a first-come, first-served basis, with priority given to people who got QI benfits the previous year. (You can't get QI benefits if you qualify for Medicaid).

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QI income & resource limits in 2020:

 

Individual monthly income limit: $1456

Married couple monthly income limit: $1960

*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 limits lister.

Individual resource limit: $7,860

Married couple resource limit: $11,800

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Program helps pay for:

Part B premiums only

Qualified Disabled and Working Individuals (QDWI) Program

The QDWI program helps pay the Part A premium. You may qualify if any of these apply to you:

  • You're a working disabled person under 65

  • You lost your premium-free Part A when you went back to work

  • You aren't getting medical assistance from your state

  • You meet the income and resource limits required by your state

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QDWI income & resource limits in 2020:

 

Individual monthly income limit: $4339

Married couple monthly income limit: $5833

*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 limits lister.

Individual resource limit: $4000

Married couple resource limit: $6000

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Program helps pay for:

Part A premiums only

What items are included in the Medicare Savings Program resource limits?

Countable resources include:

  • Money in a checking or savings account

  • Stocks

  • Bonds

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Countable resources don't include:

  • Your home

  • One car

  • Burial plot

  • Up to $1500 for burial expenses if you have put that money aside

  • Furniture

  • Other household and personal items

How do I apply for Medicare Savings Programs?

If you answer yes to these 3 questions, call your State Medicaid program to see if you qualify for a Medicare Savings Program in your state:

  1. Do you have, or are you eligible for, Part A?

  2. Is your income for 2020 at, or below, the income limits listed for any of the programs above?

  3. Do you have limited resources, below the limits above?

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It's important to call or fill out an application if you think you could qualify for savings - even if your income or resources are higher than the amounts listed here. 

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