Qualified Medicare Beneficiary Program

What is the Qualified Medicare Beneficiary (QMB) Program?

The Quality Medicare Beneficiary Program (QMB) is a program that helps Medicare beneficiaries who have rather low-incomes pay for some of Medicare’s premiums, deductibles, and copays (Medicare Part A and Part B). If you have Medicare and are within the QMB program, you will be enrolled in Medicaid which will also help with Medicare premiums and cost-sharing.

What is a Medicare Savings Program (MSP)

Medicare Savings Programs (MSP) can get help from your state when it comes to paying your Medicare premiums. If you are enrolled in MSP, you will immediately receive Extra Help for Medicare Prescription Drug plan costs. In some cases, the programs may also pay for your Medicare Part A and Part B deductibles, coinsurance, and copays if you meet the regulations. There are four main programs that have different eligibility and benefit requirements. Those include Qualified Medicare Beneficiaries (pays for Medicare Part A and B premiums), Specified Low-income Medicare Beneficiaries (pays for Medicare Part B premium), Qualified Individual Program (pays for Medicare Part B premium), Qualified Disabled Working Individuals (pays for Medicare Part A premium).

QMB Income and Resource Limits in 2018:

Individual monthly income limit*
$1,032

Married couple monthly income limit*
$1,392

Individual resource limit
$7,560

Married couple resource limit
$11,340

Program helps pay for:

• Part A premiums
• Part B premiums
• Deductibles, coinsurance, and copayments

Items Included in Medicare Savings Program Resource Limits

• Having money in savings or checking account
• Bonds
• Stocks

Not included:

• Your home
• A car
• Furniture
• Household and/or personal items
• Burial insurance or savings
• Burial plot

Eligibility for Qualified Medicare Beneficiaries

Each state determines eligibility for the QMB. They have particular state standards and regulations. Normally, states require the items listed below:

• Must be enrolled in Medicare Part A
• Resides in the same state where the applicant makes the request
• Applicant must be a Medicare Beneficiary
• Must have limited income and financial assets

How Do You Apply for Medicare Savings Programs?

1. Is your income for 2018 at, or below, the income limits that are listed above?
2. Do you have, or are eligible for Medicare Part A?
3. Do you have limited resources, below the limits that are listed above?

If you answered yes to any of these questions, be sure to call your State Medicaid Program to see if you qualify for a Medicare Savings Program in your state.

• To learn more about Medicare Part A and Medicare Part B, click here.
• To learn more about Medicare Extra Help, click here.
• To learn more about Medicare Prescription Drug (Part D) Plans, click here.