Revenue Cycle
and Billing

Medicare Savings Programs

by | Jun 3, 2016 | Uncategorized

Americans look to Medicare Savings Programs to get help paying Medicare costs.

Medicare beneficiaries face health insurance costs such as premiums, deductibles and copays to receive health benefits. Often, many of the members cannot afford the costs of the health coverage. Three main Medicare Savings Programs help folks pay for Medicare costs.

Qualified Medicare Beneficiary

Those looking to qualify for the Qualified Medicare Beneficiary program must first be eligible for Medicare. Next eligible persons must meet current income and assets limitations.

Those who enroll in the Qualified Medicare Beneficiary program do not have to pay Part A or Part B premiums. In addition, QMB enrollees are exempt from the deductibles, coinsurance or copays of Parts A or B.

What are the Income limits?

Income limitations depend on one’s tax filing status. In 2016, a single person earning below $1,010 per month qualifies for the Qualified Medicare Beneficiary program. Married couples must make no more than $1,355 per month to qualify for this Medicare Savings Program.

Not all states have the same rates for income limits. For example, Hawaii and Alaska feature higher income limits for the Qualified Medicare Beneficiary program. Those who earn slightly higher than the threshold should still apply.

What are the asset limits?

The Medicare program counts certain assets in determining eligibility for Medicare Savings Programs.  Stocks, bonds and cash in a checking or savings account count towards eligibility in a MSP.

Single persons with assets valued at no more than $7,280 qualify for the Qualified Medicare Beneficiary program. Married couples with assets less than $10,930 are eligible for the QMB program as well.

Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI) Programs

Often many Medicare-eligible Americans earn slightly more than the QMB income threshold. If this is the case, it is still possible for Medicare beneficiaries to enroll in two other Medicare Savings Programs.

These programs include the Qualifying Individual program and the Specified Low-Income Medicare Beneficiary program.

The asset limits for both of the programs are the exact same as in the QMB program. However, monthly income limitations are slightly higher. An individual must earn no more than $1,208 to qualify for the SLMB program; an individual’s income must not exceed $1,357 to qualify for the Qualifying Individual (QI) program.

Married couples must make no more than $1,622 per month to qualify for the SMLB program. Entry into the QI program requires a married couple to make no more than $1,823 per month.

Both of these programs include less benefits than the QMB Medicare Savings Program. Those who enroll in the SLMB and QI savings plans will only gather financial assistance in paying Part B premiums.

Signing Up for Medicare Savings Programs

Individuals and married couples must file separate applications for Medicare Savings Programs. State Medicaid agencies are a good place to start the application process.

More detailed information on Medicare Savings Programs can be found by clicking here.

Those with disabilities also qualify for Medicare Savings Programs. Click here for more information.

We do Medicare enrollments here at American Exchange! Call us at 1-888-995-1674 or 423-802-7829*! We would love to walk you through the process!

Philip Strang never envisioned a career in the health insurance industry before October 2015. He fell in love with the industry instantly, and his goal is to make health insurance simple for you. Feel free to write him at Comments are encouraged!

*See disclaimer below.