(Daily360.com) – When you qualify for Medicare, your general insurance includes coverage for medical care, hospitalization, special procedures, and drugs. However, premiums vary for each individual depending on how much they pay for Medicare insurance during their working years and their level of coverage. Although Medicare coverage costs are lower than private health plans, premiums, copays and deductibles can add up, putting financial pressure on seniors on fixed incomes.
The government offers four Medicare savings programs to help people pay for or reduce the cost of Medicare insurance costs. Here is an overview of each program and the eligibility criteria for receiving assistance.
Qualified Disabled and Working Individuals (QDWI) Program
The QDWI program provides assistance with Part A premiums to people over 65 with a disability who are working and have lost their Social Security Disability (SSD) benefits. Beginning in 2022, revenue and profit limits for the QDWI program are as follows:
- $4,615 individual monthly income and $6,189 married couple monthly income
- $4,000 individual resource limit and $6,000 married couple resource limit
To qualify for the QDWI program, you cannot receive health benefits from the state in which you live.
Qualifying Individual (QI) Program
The QI program is a Medicare program that helps people pay their Part B premiums if they have Medicare Part A. You must apply for QI benefits yearly and prove the less of your money and resources. Benefits are awarded on a first-come, first-served basis, and the program gives priority to people who have had QI benefits in previous years. Beginning in 2022, income and asset limits for the QI program are:
- $1,549 individual monthly income and $2,080 married couple monthly income
- $8,400 individual resource limit and $12,600 married couple resource limit
QI financial limits are higher than SLMB limits, creating the biggest difference between the two programs. If you qualify for Medicaid, you are not eligible for QI program benefits.
Specified Low-Income Medicare Beneficiary Program (SLMB)
The SLMB program helps eligible people pay for Medicare Part B premiums, which cover a variety of medical services, outpatient care, medical supplies, and preventive services. The SLMB program has financial and resources limitations. From 2022, these limits are:
- $1,379 individual monthly income and $1,851 married couple monthly income
- $8,400 individual resource limit and $12,600 married couple resource limit
Like the QMB program, limits in Alaska and Hawaii are slightly higher for the SLMB program.
Qualified Medicare Beneficiary (QMB) Program
The Qualified Medicare Beneficiary (QMB) program helps people pay premiums, deductibles, copays, and copayments for covered items and services in Parts A and B. The QMB program has significant limitations for both men and women. These limits change every year. Currently, they are:
- $1,153 individual monthly income and $1,546 married couple monthly income
- $8,400 individual resource limit and $12,600 married couple resource limit
Note: Alaska and Hawaii have higher requirements and limits for their residents. If you live in either place and your income and assets exceed the limit, you should still apply for benefits. You may be eligible for the QMB program.
Individuals eligible for the QMB program cannot be reimbursed for services or items except for outpatient treatment. By 2022, pharmacies can’t charge you more than $4 for any drug covered by Medicare Part D.
If you qualify for Medicare and have the resources and income to pay your premiums, you can get help through one of the four programs listed above. Go to the Medicare website and select your state to begin the application process. Remember, if you are just over the qualifying limits, you should still apply for help. There is no shame in needing assistance. Contact your local or state governments to learn more about these programs and whether or not you qualify.
Copyright 2023, Daily360.com
