How to Get Help with Medicare Premiums

5 Programs That Can Help

You spent a career paying into Medicare but you may find yourself struggling to pay your Medicare premiums or associated costs when you start drawing from the system. If you’re having trouble paying your medical bills you can ask for help through Medicare. Here are a few options available to you.

Medicaid

Medicaid is a joint federal and state program that helps people with limited income pay their healthcare costs.

Nearly 20 percent of Americans qualify for Medicaid—not just retirees but also children, people with certain disabilities, and many others. Because it’s a joint federal and state program, states have differing rules on qualifications. Some states choose to cover people that wouldn’t otherwise qualify under federal standards.

Because Medicaid is income based some retirees elect to spend down their assets to become eligible. By spending down a portion of their monthly income, they’ll pay less in overall healthcare costs each month.

Example: A retiree has a monthly income of $2,500 but the limit to qualify for Medicare is $2,205. They may elect to spend an extra $295 in out of pocket healthcare costs to be eligible for Medicaid. Others may elect to place a portion of their assets in an irrevocable trust or certain life insurance policies. To apply for Medicaid, .

The below 4 programs may assist low income retirees pay parts of their Medicare premiums and other associated costs. Just like Medicaid, you apply for these programs by .

Even if you don’t think you qualify for the requirements below, you may still qualify if you’re close to the limits.

Medicare advises people to apply if the person thinks they could qualify even if their income or resources are higher than what is listed below. Alaska and Hawaii, for example, have limits that are slightly higher.

Qualified Beneficiary Program

The qualified beneficiary program (QMB) is one of the 4 Medicare savings programs that qualifies you to receive help from your state to help pay for Part A and B premiums, deductibles, coinsurance, and copayments.

Income Limits:

  • Individual monthly income no higher than $1,032
  • Married monthly income no higher than $1,392
  • Individual monthly income no higher than $7,560
  • Married monthly income no higher than $11,340

Specified Low-Income Medicare Beneficiary (SLMB) Program

The Specified Low-Income Medicare Beneficiary (SLMB) Program is similar to the qualified beneficiary program but with one key difference: It only helps retirees pay Part B premiums only.

Income Limits:

  • Individual monthly income no higher than $1,234
  • Married monthly income no higher than $1,666
  • Individual monthly income no higher than $7,560
  • Married monthly income no higher than $11,340

Qualifying Individual (QI)

The qualifying income (QI) program helps individuals with their Part B benefits. You must apply each year for QI benefits and they are granted on a first-come, first-served basis.

People who received benefits the prior year are given priority. If you receive Medicaid you aren’t eligible for this program.

Income Limits:

  • Individual monthly income no higher than $1,386
  • Married monthly income no higher than $1,872
  • Individual monthly income no higher than $7,560
  • Married monthly income no higher than $11,340

Qualified Disabled and Working Individuals (QDWI) Program

The Qualified Disabled and Working Individuals (QDWI) Program helps retirees pay their Part A premiums. To qualify you must be a working disabled person under the age of 65, you lost your premium-free Part A when you returned to work, you aren’t receiving medical assistance from your state, and you meet income and resource limits required by your state.

Income Limits:

  • Individual monthly income no higher than $4,132
  • Married monthly income no higher than $5,572
  • Individual monthly income no higher than $4,000
  • Married monthly income no higher than $6,000

To be eligible for any of these programs you can’t exceed the resource limits. Much like Medicare you may have to spend down your resources to meet the eligibility requirements. Countable resources include money in checking or savings accounts, stocks, bonds, and some other investment types. Non-countable resources include assets like your home, car, burial plot, up to $1,500 in burial expenses if you set aside money, furniture and many other personal items.

Note: The income limits above are the 2018 limits. Limits may change each year. To see the most up to date income limits, check the page.