Medicare Cost-Sharing Plans

Medicare is the national health insurance program for people age 65 or older and those with disabilities. Medicare has two parts: Part A is hospital insurance and is FREE. Part B is supplementary medical insurance and has a premium. There are three programs available for limited income Medicare recipients to fully or partially help them pay for the Part A and/or Part B premiums.

QMB Program (Qualified Medicare Beneficiary Program)

The QMB program is available to Medicare beneficiaries who have limited income and few assets.
QMB pays the Medicare Part B premium, the coinsurance of 20 percent for Medicare-covered services and the Medicare deductible.

To qualify for QMB, Medicare beneficiaries must have a monthly income at, or below, the poverty level: $801, or below, for one person or $1,066 for a couple. This income includes Social Security benefits, pensions and all other interest payments and income.

SLIB Program (Specified Low-Income Beneficiary Program)

The SLIB Program covers the Medicare Part B premiums for beneficiaries whose income is between 100 and 120, percent of the federal poverty level: $956 per month for one person; $1,274 per month for two.

QI Program (Qualified Individual Program)

The QI Program covers the Medicare Part B premium for beneficiaries whose income is between 120 and 135 percent of the federal poverty level: $1,072 per month for one person; $1,430 per month for two.

Other Eligibility Factors

Assets, including bank accounts and stocks and bonds, cannot exceed $4,000 for one or $6,000 for a family of two. Some assets and possessions are exempt, including a home, car, burial plot and some life insurance.

How does the program work?

Medicare premiums are not withdrawn from participants’ social security check. Additionally, participants’ doctors bill the state for medical services instead of the individual.