There are 4 Medicare Savings Programs available to those who have both Medicare and Medicaid with a low income. Here’s what they cover and how to qualify.
The 4 Different Medicare Savings Programs—How to Qualify
Medicare Savings Programs (MSPs) are available to Medicare-eligible individuals who have limited monetary availability and stability. They are not available to everyone, then, but only those who fall under certain income and resource limitations:
- The Qualified Medicare Beneficiary Program (QMB) is limited to those who have under a $1,084 individual or $1,457 couples monthly income, and/or are at 100% of the Federal Poverty Line (FPL).
- The Specified Low-Income Medicare Beneficiary Program (SLMB) is limited to those who have under a $1,296 individual or $1,744 couples monthly income, and/or are at 120% of the FPL.
- The Qualifying Individual Program (QI) is limited to those who have under a $1,456 individual or $1,960 couples monthly income, and/or are at 135% of the FPL.
- The Qualified Disabled and Working Individuals Program (QDWI) is limited to those with disabilities, who have under a $4,339 individual or $5,833 couples monthly income.
- For the QMB, SMLB, and QI programs, you are only allowed $7,860 worth in resources for an individual and $11,800 for a married couple. For the QDWI program, you are allowed $4,000 for an individual and $6,000 for a married couple.
Qualified Medicare Beneficiary Program (QMB)
Each MSP covers a variety of the expenses charged under Original Medicare and Medicare Part D. The QMB program pays for:
- Part B premiums (and Part A premiums, if you have them)
- Part A and B deductibles
- Coinsurance/copayments (not including those for outpatient prescriptions)
- Pharmacists may charge you no more than $4 for Part D covered prescriptions in 2021
Specified Low-Income Medicare Beneficiary Program (SLMB)
For the SLMB program, your Part B premiums will be covered. And, like all 4 MSPs, you also have automatic access to the Part D Extra Help program, which greatly reduces all charges from a traditional Part D plan.
Qualifying Individual Program (QI)
The QI program covers your Part B premium. You must reapply to continue to receive this benefit each year, and you are not guaranteed acceptance. It’s perfect for those who have a lower income than most, but don’t quite qualify for the fuller benefits available to those with even lower incomes.
Qualified Disabled and Working Individuals Program (QDWI)
The QDWI pays your Part A premium. However, most Medicare beneficiaries qualify for premium-free part A, and don’t have to worry about this cost in the first place. The QDWI is special, then, because it helps those who lost premium-free Part A.
Understand Your Medicare Coverage with Swisher Insurance—Call Today
As a lower-income individual, you may have a hard time finding what Medicare programs are available to you. Whatever the case may be, we are here to help. Call Swisher Insurance at 502-259-0780.
