Paying for Medicare on a Limited Income

Medicare Extra Help

Getting help paying Medicare premiums can be achieved by applying through your state

If you have limited income and resources, you may be able to get help paying your Medicare Part A and/or B premium from your state. You could also qualify for the Extra Help program for help paying your Medicare prescription drug benefits.

There are actually several savings programs available. Read about them below:

The Qualified Medicare Beneficiary (QMB) program

This program helps to pay for Medicare Part A and / or Part B premiums, as well as helps you with deductibles, copayments, and / or coinsurance costs. In 2018, the individual resource limit is $7,560, and the married couple resource limit is $11,340. Income limits are also in place. It is important that you make sure that your health care provider knows that you are in the Medicare Qualified Medicare Beneficiary program. In doing so, provide your provider(s) with your regular Medicare or Medicaid ID card and / or your QMB card each time you receive services. It can also be beneficial to remind your health care providers that because you are in the QMB program, you cannot be charged for Medicare deductibles, copayments, and / or copayments. For further assistance, you can contact Medicare directly at 1-800-633-4227.

The Specified Low Income Medicare Beneficiary (SLMB) program

With the SLMB program, you can obtain help with paying your Medicare Part B premiums. As with the QMB program, there are both income and resource limits, and the amount of these will be based on whether you are single or married. For instance, the monthly income limit for a single individual (in 2018) is $1,234, and for married couples it is $1,666. The resource limit for a single person is $7,560 and for married couples $11,340. Note that these limits will likely increase for 2019, so even if your income and resource amounts are slightly higher, it can still be worthwhile for you to apply.

The Qualifying Individual (QI) program

The QI program can help you with paying your Medicare Part B premiums. You must apply each year for these benefits. QI applications are granted on a first come, first served basis, with priority given to those who received such benefits in the previous year. It is important to be aware that you cannot receive QI benefits if you also qualify for Medicaid benefits. Here, too, there are both income and resource limits for single individuals, as well as for married couples.

The Qualified Disabled and Working Individuals (QDWI) program

With the QDWI program, you can receive assistance with paying your Medicare Part A premium. You may qualify for the QDWI program if you are a working disabled person who is under age 65 and / or if you lost your premium-free Medicare Part A when you returned to work. Other qualification factors could include you not receiving other medical assistance from your state, or you meet the income and resources limits that are required by your state. In this case, the individual monthly income limit for 2018 is $4,143, and the monthly QDWI income limit for married couples is $5,572. Likewise, the individual 2018 resource limit is $4,000 and the married couple resource limit for the QDWI program is $6,000. Here again, these amounts are likely to go up for the 2019 year. So, be sure to apply – even if your income and resource limits are slightly higher than those for 2018.

When it comes to the resources that are and are not counted for the Medicare Savings Program, includable resources can include money in a checking and / or savings account, as well as any stocks and / or bonds you may have.
On the other hand, countable resources do not include your home, one vehicle, a burial plot (if you own one), furniture, other household and personal items, and up to $1,500 for your burial expenses, if you have put such funds aside.

How to Apply

To receive and of these benefits, call or visit the department that administers Medicaid in your state — usually your state’s Department of Social Services or Social Welfare Department. Each state has its own application procedure, and it’s worth filling out an application even if you think that your income is too high, because you may qualify for one of the two other state assistance programs: the Specified Low-Income Medicare Beneficiary Program and the Qualifying Individual Program. Disabled workers may also qualify for the Qualified Disabled and Working Individuals Program. These programs give fewer benefits, but the income limits are higher, depending on the program.

To find a Social Services Office in your state, here’s a link you might find to be helpful.

You can also find your State Health Insurance Assistance Program (SHIP) by clicking here.

Note that if you qualify for a QMB, SLMB, or QI program, then you will also automatically qualify to receive benefits from the Extra Help program. With the Extra Help program, you may qualify for assistance from Medicare with paying for your Medicare Part D prescription drug coverage. Here, too, you must meet certain income and resource limits. If you do not qualify for Medicare Extra Help, then it is still possible that you could qualify for various programs in your state.


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Author Bio: Ben started Prepare for Medicare in 2014 to help people help people get objective answers to questions about Medicare. He’s held leadership roles at numerous Fortune 500 Medicare health insurers in product development, sales, marketing and strategy for over 20 years.