Get Help Paying Your Medicare Costs

Get Help Paying Your Medicare Costs

Did you know that you may be able to get help from your state to pay your Medicare premiums? State-based Medicare Savings Programs may also pay Medicare Part A (hospital insurance) (http://www.medicare.gov/your-medicare-costs/help-paying-costs/medicare-savings-program/medicare-savings-programs.html#1367) and Part B (medical insurance) deductibles, co-insurance (http://www.medicare.gov/your-medicare-costs/help-paying-costs/medicare-savings-program/medicare-savings-programs.html#1294) and co-payments.

If you have income from working, you may qualify for these programs even if your income is higher than the income limits listed below.

There are four types of Medicare Savings Programs:

  • Qualified Medicare Beneficiary (QMB) Program: Helps pay for your Part A and/or Part B premiums, deductibles, co-insurance and co-payments.
  • Specified Low-Income Medicare Beneficiary (SLMB) Program: Helps pay your Part B premiums only.
  • Qualifying Individual (QI) Program: Helps pay your Part B premiums only. You must apply each year for QI benefits, and the applications are granted on a first-come, first-served basis. Priority is given to people who received QI benefits the previous year. (You cannot receive QI benefits if you qualify for Medicaid.)
  • Qualified Disabled and Working Individuals (QDWI) Program: Helps pay your Part A premiums only. You may qualify for this program if you have a disability and are working.

The names of these programs and how they work may vary from state to state. If you qualify for a QMB, SLMB or QI program, you automatically qualify to get Extra Help (http://www.medicare.gov/your-medicare-costs/help-paying-costs/get-help-paying-costs.html) to help you pay for your Medicare prescription drug coverage (Part D) plan.

If you answer “yes” to the following three questions, call your state Medicaid office (http://www.medicare.gov/Contacts/Default.aspx) to see if you qualify for a Medicare Savings Program:

 

  1. Do you have, or are you eligible for, Medicare Part A?
  2. Is your income for 2014 at, or below, the income limits listed below?
  3. Do you have limited resources, below the limits below?

The amounts that follow may increase in 2015. However, it is important that you call or fill out an application if you think you may qualify for savings, even if your income or resources are higher than the amounts listed here.

Qualified Medicare Beneficiary (QMB) Program. Individual monthly income limit: $993; married couple monthly income limit: $1,331.

Specified Low-Income Medicare Beneficiary (SLMB) Program. Individual monthly income limit: $1,187; married couple monthly income limit: $1,593.

Qualifying Individual (QI) Program. Individual monthly income limit: $1,333; married couple monthly income limit: $1,790.

Qualified Disabled and Working Individuals (QDWI) Program. Individual monthly income limit: $3,975; married couple monthly income limit: $5,329.

(Limits are slightly higher in Alaska and Hawai‘i. If you have income from your employment, you may qualify for benefits even if your income is higher than the limits listed.)

Resource limits for the QMB, SLMB, and QI programs are $7,160 for one person and $10,750 for a married couple. Resource limits for the QDWI program are $4,000 for one person and $6,000 for a married couple.
Countable resources include money in a checking or savings account, stocks and bonds. Countable resources do not include your home, one car, a burial plot, up to $1,500 for burial expenses if you have set aside that money, furniture, and other household and personal items.

David Sayen is Medicare’s regional administrator for Hawai‘i California, Nevada, Arizona and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227)

David Sayen is Medicare’s regional administrator for Hawai‘i, California, Nevada, Arizona and the Pacific Territories.

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