What Are Medicare Savings Programs?

by | Feb 18, 2021

Medicare Savings Programs are designed to help those with lower incomes and limited resources afford the healthcare they need.

Money in your checking or savings account, stocks, and bonds are countable resources. Your home, one car, burial plot, up to $1,500 set aside for burial expenses, furniture, and household items do not count toward your resources.

There are four types of Medicare Savings Programs. These include:

  • Qualified Medicare Beneficiary (QMB) Program
  • Specified Low-Income Medicare Beneficiary (SLMB) Program
  • Qualified Individual (QI) Program
  • Qualified Disabled and Working Individuals (QDWI) Program

The Qualified Medicare Beneficiary (QMB) Program 

The Qualified Medicare Beneficiary (QMB) program helps to pay for your Part A premiums, Part B premiums, Part A and Part B deductibles, coinsurance, and copayments. Healthcare providers are not allowed to bill you for covered services except for outpatient prescriptions. Part D-covered prescriptions are limited to a low copay. If you have already paid for Medicare-covered services you should not have been charged for, you have the right to a refund.

To qualify for the QMB program, you must be within the income and resource limits. Income limits are slightly higher in Alaska and Hawaii. Individuals have a monthly income limit of $1,084 and a resource limit of $7,860. Married couples have a monthly income limit of $1,457 and a resource limit of $11,800.

Specified Low-Income Medicare Beneficiary (SLMB) Program

The Specified Low-Income Medicare Beneficiary (SLMB) Program helps to pay for Part B premiums.

To qualify for the SLMB program, you must meet the following limitations. Individuals have a monthly income limit of $1,296 and a resource limit of $7,860. Married couples have a monthly income limit of $1,744 and a resource limit of $11,800. Income limits are higher in Hawaii and Alaska.

Qualifying Individual (QI) Program

The Qualifying Individual (QI) program helps to pay for Part B premiums for those who meet income limits and do not qualify for Medicaid. You need to apply every year, and access is granted on a first-come, first-served basis with priority given to those who received QI benefits the previous year.

To qualify for the QI program, you must meet income and resource limits. Individuals have a monthly income limit of $1,456 and a resource limit of $7,860. Married couples have a monthly income limit of $1,960 and a resource limit of $11,800. Income limits are slightly higher in Alaska and Hawaii.

Qualified Disabled and Working Individuals (QDWI) Program

The Qualified Disabled and Working Individuals (QDWI) program pays the Part A premium for those with disabilities who lost their premium-free Part A due to returning to work.

To qualify for the QDWI program, you must be a working disabled person under the age of 65 who is not receiving medical assistance from your state. You must also meet income and resource limits. The individual monthly income limit is $4,339 and the resource limit is $4,000. For married couples, the monthly income limit is $5,833 and the resource limit is $6,000.

Extra Help

People who qualify for the QMB, SLMB, or QI programs also qualify for Extra Help, the program which reduces your prescription costs. In 2021, your costs will be no more than $3.70 for generic covered prescription drugs and no more than $9.20 for brand-name covered drugs.

To learn more about Medicare and how to save money through these specific programs, reach out to The Fussell Group Insurance Advisors today.