Get help with Medicare Premiums

By David Sayen;                                                                                                                                             

Did you know that you may be able to get help from your state paying your Medicare premiums? State-based Medicare Savings Programs also may pay Medicare Part A (hospital insurance) and Part B (medical insurance) deductibles, coinsurance, and copayments.

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 kinds of Medicare Savings Programs:

  • Qualified Medicare Beneficiary (QMB) Program—Helps pay for your Part A and/or Part B premiums, deductibles, coinsurance, and copayments.
  • 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, with priority given to people who got QI benefits the previous year. (You can't get 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 by state. If you qualify for a QMB, SLMB, or QI program, you automatically qualify to get Extra Helppaying for your Medicare prescription drug coverage (Part D) plan.

If you answer yes to the three questions below, call your State Medicaid office to see if you qualify for a Medicare Savings Program:

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

The amounts that follow may increase in 2015. But 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.

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 Hawaii. If you have income from working, 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 don't include your home, one car, a burial plot, up to $1,500 for burial expenses if you have put that money aside, furniture, and other household and personal items.

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

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