DreamhealthQuotes, discover the four Medicare Savings Programs.
We can assist you in determining the additional support for which you may be qualified.
The Medicare Savings Program: What Is It?
The goal of a Medicare Savings Program (MSP) is to make Medicare more affordable for eligible individuals. There are four distinct programs, each of which is managed at the state level and has its own eligibility requirements in terms of resources and income.
The Four Medicare Savings Programs
- Qualified Medicare Beneficiary (QMB) Program
Individuals can get assistance with paying for healthcare through the Qualified Medicare Beneficiary (QMB) Program. Medicare Part A (where applicable) and Medicare Part B premium payments are made by the government on behalf of eligible beneficiaries each month. Deductibles, co-insurance payments, and some prescription medication costs are also covered.
- QMB Program Requirements and Income Caps
- You must meet specific income requirements to be eligible for QMB assistance.
- Maximum monthly income per person: $1,235
- Monthly income ceiling for a married couple: $1,663
- Limit of individual resources: $9,090
- Maximum resources for a married couple: $13,630
For further details, please feel free to visit https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs
- QMB Program Features
One of the four savings programs created by Medicare to assist low-income beneficiaries in paying their premiums, deductibles, and coinsurance is the Qualified Medicare Beneficiary (QMB) Program. A Medicare member who is eligible for the QMB program will also be eligible for the Medicare Part D Extra Help program, which offers financial assistance with the cost of prescription medications, automatically.
Those that meet the requirements for the QMB program may receive financial assistance with:
- Medicare premiums for Part A
- Medicare premiums for Part B
- Deductibles for Medicare
- Medicare services coinsurance.
- Some Medicare Part D premiums for prescription medication plans
- Some of the Medicare drug expenditures
Applying to the QMB Program
You must speak with the Medicaid office in your state if you want to apply for the QMB Program.
For further details, please feel free to visit https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs
2. Specified Low Income Medicare Beneficiary (SLMB) Program
The Specified Low Income Medicare Beneficiary (SLMB) Program assists those with Medicare Part A, a low monthly income, and few resources in paying their Part B premiums.
Qualifications for the SLMB Program and Income Cap
You must fulfill specific income conditions in order to be eligible for SLMB benefits.
- Maximum monthly income per person: $1,478
- Maximum monthly income for a married couple: $1,992
- Limitation of personal resources: $9,090
- Resource ceiling for a married couple: $13,630
How Do You Apply for the SLMB Program?
You must contact the Medicaid office in your state in order to submit an application for the SLMB Program.
For further details, please feel free to visit https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs
3. The Qualifying Individual (QI) Program
Medicare Part B premiums are also partially covered under the Qualifying Individual (QI) Program. Benefits under this program must be reapplied for each year, and preference is given to people who received benefits under the program the previous year. Benefits are awarded on a first-come, first-served basis.
Qualifications for the QI Program and Income Caps
You must fulfill specific income conditions in order to be eligible for QI Program benefits.
- Maximum monthly income for an individual: $1,660
- Maximum monthly income for a married couple: $2,239
- Limitation of personal resources: $9,090
- Resource ceiling for a married couple: $13,630
For further details, please feel free to visit https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs
- QI Program Features
Every savings program is different, so if you have discovered that you are not eligible for a QMB or SLMB, it may be worthwhile to apply for the Qualifying Individual (QI) Program in order to perhaps obtain Extra Help paying for Medicare Part B premiums. Furthermore, if you meet the requirements for this program, you are immediately eligible for the Extra Help prescription medicine program.
Remember that you must reapply for the QI Program every year, and that although prior recipients are given priority, the benefits are given out on a first-come, first-served basis.
Applying for the QI Program
To apply for the QI Program, get in touch with the Medicaid office in your state.
For further details, please feel free to visit https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs
4. Qualifying Disabled and Working Individuals (QDWI) Program
Medicare Part A premiums are partially covered by the Qualifying Disabled and Working Individuals (QDWI) Program, a Medicaid program run by the state. People with disabilities under 65 who are employed may be eligible for this program.
Qualifications for the QDWI Program and Income Caps
If any of the following conditions applies to you, you may be eligible for the QDWI Program:
- You’re under 65 and a working disabled person.
- When you returned to work, you lost your premium-free Part A. You do not receive medical assistance from your state.
- You are inside your state’s mandated income and resource limits.
The restrictions on resources and income are:
- Maximum monthly income for an individual: $4,945
- Maximum monthly income for a married couple: $6,659
- Limitation on personal resources: $4,000
- Resource ceiling for a married couple: $6,000.
QDWI – Benefits
In contrast to the other three Medicare Savings Programs, the Qualifying Disabled and Working Individuals (QDWI) Program exclusively covers Medicare Part A premiums.
Application Process for QDWI Program
You may get in touch with the Medicaid office in your state to apply for the QDWI Program.
For further details, please feel free to visit https://www.medicare.gov/your-medicare-costs/get-help-paying-costs/medicare-savings-programs
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