What Is A Medicare Savings Program And How Do You Qualify?

If you are currently looking into applying for Medicare or are already utilizing Medicare benefits, chances are, you have heard the term Medicare Savings Program thrown around. But, what is a Medicare Savings Program? And, more importantly, how do you qualify for one of the various Medicare Savings Programs? Keep reading to find out the answers to both of these important questions!

What Is A Medicare Savings Program?

The various Medicare Savings Programs are designed to help Medicare-age individuals with lower incomes cover the cost of some of the out-of-pocket expenses for Medicare. Depending on the program, Medicare Savings Programs can help medicare-age individuals pay for some or even all of the following:

Another added benefit of a Medicare Savings Program is that, depending on the program, you could automatically qualify for the Extra Help Program, too. This is a great program because it helps individuals cover the cost of their Medicare prescription drug plans. In fact, the Extra Help Program is estimated to be worth about $5,000 a year!

The Different Types Of Medicare Savings Programs

There are four types of Medicare Savings Programs:

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

The benefits and eligibility requirements for each program vary.  

Qualified Medicare Beneficiary Program (QMB)

The Qualified Medicare Beneficiary Program  (QMB) is great because it helps individuals pay for both Medicare Part A and Medicare Part B premiums. Its funds can also be used toward deductibles, coinsurance, and copayments.

In order to apply for the Qualified Medicare Beneficiary Program, you must already be enrolled in Medicare Part A and meet certain income and resource requirements. If you qualify for the QMB Program, then you automatically qualify for the Extra Help Program, too.

Specified Low-Income Medicare Beneficiary (SLMB) Program

If you don’t meet the income requirements for the Qualified Medicare Beneficiary Program, there is a good chance you might qualify for the Specified Low-Income Medicare Beneficiary Program (SLMB). 

However, unlike the QMB Program, the SLMB Program only helps pay for Medicare Part B premiums. And, it can’t be used towards other costs, like deductibles or coinsurance. But, if you qualify for the SLMB Program, you automatically qualify for the Extra Help Program, which is quite helpful. 

Qualifying Individual Program (QI)

 If you don’t qualify for either the QMB or SLMB programs, you might be eligible for the Qualifying Individual Program (QI). Like the SLMB Program, the QI Program only pays for Medicare Part B premiums. But, if you qualify, then you automatically qualify for the Extra Help Program. 

One thing to keep in mind about the Qualifying Individual Program is that funding is limited. This means that benefits are only given to qualifying individuals on a first-come, first-serve basis. Additionally, priority is given to those who were receiving QI benefits the year before. Another thing to keep in mind about this program is that if you have Medicaid, you can’t qualify for it.

Qualified Disabled and Working Individuals (QDWI) Program

The Qualified Disabled and Working Individuals Program (QDWI) only covers costs for Medicare Part A premiums. And, it has very strict qualifying requirements.

You should only apply for the QDWI Program if:

  • You lost your premium-free Medicare Part A coverage due to returning to work
  • You are currently disabled and working, but you are under the age of 65
  • You aren’t currently getting any medical assistance from your state
  • You meet the income and resource requirements for your state

Qualifying for the QDWI Program does not automatically qualify you for the Extra Help Program.  

How Do You Qualify For One Of The Medicare Savings Programs?

The qualifications for the Qualified Medicare Beneficiary Program, Specified Low-Income Medicare Beneficiary Program, and Qualifying Individual Program are different than the qualifications for the Qualified Disabled and Working Individuals Program.

In order to qualify for the QMB, SLMB, or QI programs, you must be eligible for Medicare Part A as well as meet specific income and resource requirements. And, like we said earlier, there are very strict requirements for the QDWI program.

Another thing to remember is that these income and resource requirements can change each year. So, if you don’t qualify for a program the first time you apply, you might qualify the next year, and vice versa. 

How Eligibility For The Various Medicare Savings Programs Is Determined

Because eligibility for the various Medicare Savings Programs is based on finances and resources, the following will be counted when determining whether or not you are eligible:

  • Checking accounts
  • Savings accounts
  • Stocks
  • Bonds
  • Mutual funds
  • Individual Retirement Accounts (IRAs)

Get In Touch With An Agent Today 

If you are in need of a Medicare Savings Program, it’s time to talk to Cheryl https://medicarevalue.com/cherylshg/contact-us

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