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Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant) and has four parts.
- Overview
- About Medicare savings programs
- What is a QI program?
- Eligibility
- Income limits
- Exceptions
- Benefits
- Medicaid and QI together
- Other options
- Summary
The QI Medicare savings program helps those on a low income to pay for their Medicare Part B monthly premiums.
The Qualifying Individual or QI program is a Medicare savings program (MSP). Medicare provides four savings programs with different income and resource limits.
To receive the program benefits, a person must meet financial criteria and reapply annually.
This article explores the QI Medicare savings program, eligibility, income limits, and how to apply.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
•Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
The government provides help for individuals to pay their Medicare premiums and, sometimes, the cost-sharing expenses.
To qualify, a person must meet certain conditions. Employed individuals may apply if their income is within specified limits.
Four kinds of MSPs exist:
•Qualified Medicare Beneficiary (QMB) program
•Specified Low-Income Medicare Beneficiary (SLMB) program
•Qualifying Individual (QI) program
The Qualifying Individual (QI) program is the third level of MSPs. If an individual does not qualify for QMB or SLMB programs, they should consider the QI program.
The QI program covers Part B premiums only. However, most people do not pay a premium for Part A.
A person must reapply each year to continue receiving MSP benefits.
The programs do not have unlimited funding, and priority goes to the people who received QI benefits the previous year.
To receive QI benefits, people must have Part A or be eligible and have income and resources below a specified limit.
The eligibility requirements can differ between states and from year to year.
When the Medicaid agency looks at someone’s application for a QI program, they consider the following resources:
•checking and savings accounts
•bonds
•stocks
Medicaid agencies use the Federal Poverty Level (FPL) to calculate the QI program’s income limits.
Qualifying individuals can have an income of 120-135% FPL.
The calculations can differ according to the state. Alaska and Hawaii have higher limits than the rest of the USA.
To enroll in the QI program, an individual must meet the monthly income limits. In most states, this includes a $20 general income disregard.
For a single person, the limit is $1,456 per month.
For a married couple, the combined income must be less than $1,960 per month.
Some states have different qualifying limits:
In Alaska, the single person limit is $1,815, or $2,445 for a married couple.
In Hawaii, the single person limit is $1,672 or $2,251 for a married couple.
Exceptions to the general income disregard include:
•Maine ($75)
•Mississippi ($50)
Decreased Medicare costs
In 2021, the Part B premium costs $148.50 per month. Because the QI program covers this cost, a person can save $1,782 annually.
Automatic Extra Help
When someone qualifies for the QI Medicare savings program, they can receive the Medicare Part D low-income subsidy. Also known as Extra Help, the program provides financial assistance for prescription drugs. The Social Security Administration values savings for the average person through the Extra Help program at around $5,000 per year. If someone does not already have a Part D plan, they can enroll with no late enrollment penalty once they qualify for Extra Help.
An individual cannot have Medicaid and a QI plan at the same time. Although the Medicaid agency administers both types of programs, there are differences between them.
Medicaid pays for a range of healthcare services for those with low income and resources, not just the monthly premium.
Each state offers Medicaid programs with varying eligibility criteria and benefits.
For example, in New York, to qualify for the QI program, an individual cannot exceed a gross monthly income of $1,456. For a person to be eligible for Medicaid, the total monthly income limit is $895.
Medicare Plan Finder
The government Medicare Plan Finder tool is a database of available coverage and benefits. Individuals answer questions to find out the benefit options they have, and which Medicare plans they may like to consider.
The State Health Insurance Assistance Program (SHIP)
This government-funded service provides free advice from volunteers who understand Medicare. People can ask questions and receive personalized information about saving on their Medicare costs. The SHIP website provides online help and details of local offices.
The Medicare QI savings program helps those with a lower income to pay their Part B premiums.
People who qualify can also receive Extra Help, which assists with prescription drug costs.
Jun 10, 2024 · a monthly income limit of $1,275. an asset limit of $9,430. Specific financial requirements for the QMB for married couples are: a monthly income limit of $1,724. an asset limit of $14,130. If you ...
Jun 21, 2024 · Medicare Savings Programs Help Pay Medicare Costs for Qualified Low-Income Individuals. The QMB, SLMB, and QI programs help pay Medicare premiums, deductibles, and co-pays. Learn how to qualify in 2024. By Joseph Matthews, J.D. UC Berkeley School of Law. Updated by Bethany K. Laurence, Attorney UC Law San Francisco.
- If you are eligible for Medicare and meet the income and asset eligibility requirements for the QMB program, your state's QMB program will pay all...
- If your income is slightly too high for you to qualify for QMB benefits, you may still be eligible for one of two other state medical assistance pr...
- Before you can get coverage by the QMB, SLMB, or QI programs, you must file a written application separate from your Medicare application. If you a...
- If you are denied eligibility for QMB, SLMB, or QI, you have a right to appeal. If you believe you should be eligible for one of he programs, go to...
- If you are denied QMB, SLMB, or QI, you may want to consult with someone experienced in the subject to help you prepare your appeal. One place you...
Aug 28, 2024 · QMB income limits. Someone can enroll in a QMB program providing they meet the monthly income limits. In 2024, the limit for an individual is $1,275 per month. For a married couple, the combined ...
5 days ago · There are four Medicare Savings Programs that help cover some of the out-of-pocket Medicare costs for people with limited income and resources. The exact eligibility criteria can vary slightly by state, so Medicare recommends applying even if you are not sure whether you will qualify.
People also ask
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Medicare Savings Programs (MSPs), also known as Medicare Buy-In programs or Medicare Premium Payment Programs, help pay your Medicare costs if you have limited income and savings. There are three main programs, each with different benefits and eligibility requirements.*. Qualified Medicare Beneficiary (QMB): Pays for Medicare Parts A and B ...
