Medicare QMB Savings: How To Cut Your Expenses In Half
Medicare And Medicaid Savings For Qualified Beneficiaries (QMB)If you are entitled to receive Medicare and have a low income, your State may pay some or all of your Medicare QMB savings expenses. State Medicaid programs pay Medicare costs for certain elderly and disabled persons with low incomes and very limited assets. What this means is that, depending on your income and the value of things you own, you will not have to pay some or all of your out-of-pocket expenses for hospital, physician, and other services covered by Medicare. You could save hundreds if not thousands of dollars each year.
Several Programs Offer Medicare HelpThere are several programs to help people pay their Medicare expenses:
- The Qualified Medicare Beneficiary or QMB program
- The Specified Low-income Medicare Beneficiary or SLMB program
- The Qualifying Individual or QI program.
- Medicare’s hospital deductible which is $764 per benefit period in 1998.
- The daily coinsurance charges for extended hospital and skilled nursing facility stays.
- The Medicare Supplementary Medical Insurance (Part B) premium, which is $43.80 per month in 1998. The $100 annual Part B deductible.
- The 20-percent coinsurance for services covered by Medicare Part B, depending on which doctor you see.
- The $43.80 monthly Part B premium.
- The State will pay the premium for you. You will, however, continue to be responsible for Medicare’s deductibles, coinsurance, and for charges for health care services and medical supplies not covered by Medicare.
How Do I Qualify Medicare And Medicaid Savings?The rules may vary from State to State but, in general terms, to qualify for assistance under the QMB program, you must meet the following requirements:
- You must be entitled to Medicare Part A. If you do not have Part A or do not know whether you are entitled to Part A, check with any Social Security Administration office or call 1-800-772-1213.
- Most people are entitled to Part A based on their own employment or the employment of a spouse. Even if you or your spouse did not work or did not work long enough to entitle you to Part A, your State may buy it for you.
- All States except Alaska and Hawaii $691 (individual) $925 (couple) Alaska $860 (individual) $1,151 (couple) Hawaii $792 (individual) $1,060 (couple) Income includes, but is not limited to, Social Security benefits, pensions and wages.
- Interest payment and dividends can also count as income.
What If My Income Is Slightly Higher Than The Poverty Level?If you do not qualify for QMB assistance because your income is too high, you may be able to get help under the SLMB or QI program. To qualify for SLMB assistance, you must meet requirements in number 1 and 2 listed under the previous section. Also, your income cannot exceed the national poverty level by more than 20 percent. This means that in 1998 the SLMB monthly income limits (including a $20 income disregard) are:
- All States except Alaska and Hawaii $825 (individual) $1,105 (couple) Alaska $1,027 (individual) $1,377 (couple) Hawaii $946 (individual) $1,268 (couple).
- If you do not qualify for SLMB assistance because your income is too high, you may be able to get help under the QI program.
- All States except Alaska and Hawaii $926 (individual) $1,241 (couple) Alaska $1,153 (individual) $1,547 (couple) Hawaii $1,062 (individual) $1,424 (couple).
- If your income exceeds the 35 percent limit but is less than 75 percent of the national poverty level, the State may pay part of your Medicare Part B premium.
- All States except Alaska and Hawaii $1,194 (individual) $1,603 (couple) Alaska $1,489 (individual) $1,999 (couple) Hawaii $1,371 (individual) $1,840 (couple)