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. These conditions are listed below under "How do I apply for Medicare Savings Programs?"
4 kinds of Medicare Savings Programs
If you have income from working, you may qualify for these 4 programs even if your income is higher than the income limits listed below.
QMB income & resource limits in 2016:
Individual monthly income limit*
$1,010
Married couple monthly income limit*
$1,355
Individual resource limit
$7,280
Married couple resource limit
$10,930
Program helps pay for:
- Part A premiums
- Part B premiums
- Deductibles, coinsurance, and copayments
Medicare providers aren’t allowed to bill you for Medicare deductibles, coinsurance, and copayments when you get services and items Medicare covers, except outpatient prescription drugs. Pharmacists may charge you up to a limited amount (no more than $3.70 in 2017) for prescription drugs covered by Medicare Part D.
To make sure your provider knows you have QMB, show both your Medicare and Medicaid or QMB card each time you get care. If you get a bill for medical care Medicare covers, call your provider or plan about the charges. Tell them that you have QMB and can’t be charged for Medicare deductibles, coinsurance and copayments. If this doesn’t resolve the billing problem, call 1-800-MEDICARE (1-800-633-4227).
SLMB income & resource limits in 2016:
Individual monthly income limit*
$1,208
Married couple monthly income limit*
$1,622
Individual resource limit
$7,280
Married couple resource limit
$10,930
Program helps pay for:
Part B premiums only
You must apply every year for QI benefits. QI 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).
QI income & resource limits in 2016:
Individual monthly income limit*
$1,357
Married couple monthly income limit*
$1,823
Individual resource limit
$7,280
Married couple resource limit
$10,930
Program helps pay for:
Part B premiums only
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
QDWI income & resource limits in 2016:
Individual monthly income limit*
$4,045
Married couple monthly income limit
$5,425
Individual resource limit
$4,000
Married couple resource limit
$6,000
Program helps pay for:
Part A premiums only
If you qualify for a QMB, SLMB, or QI program, you automatically qualify to get Extra Help paying for Medicare prescription drug coverage.
These amounts may increase in 2017. If your income and resources are slightly higher, you should still apply.
*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.
What items are included in the Medicare Savings Program resource limits?
Countable resources include:
- Money in a checking or savings account
- Stocks
- Bonds
Countable resources don't include:
- Your home
- One car
- Burial plot
- Up to $1,500 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:
- Do you have, or are you eligible for, Part A?
- Is your income for 2016 at, or below, the income limits above?
- Do you have limited resources, below the limits above?
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.
How can I keep my costs down?
- Make sure your Medicare card [JPG] is valid and that you've paid your Part B premium.
- Go to a doctor, other health care provider, or supplier that accepts assignment.
- Read about how to get help with medical and prescription drug costs.