4 secret Medicare savings programs you should know about

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Having trouble paying your Part A and Part B premiums for in-hospital stays and outpatient visits, respectively?

There are several little-known Medicare savings programs that could help you foot the bill.

Check out these Medicare savings programs

Amid a flurry of proposed changes to Medicare, one that looks like it may stick would require hospitals to post their prices online in a machine-readable form. The goal is to make it easier for you to comparison shop services from one hospital to another.

But what if you can’t afford your Part A premiums for hospitalization in the first place — or your Part B premiums, for that matter?

That’s where secret Medicare savings programs can help. There are four such programs that can assist with paying for premiums and more.

Each of the four programs has its own income and resource limitations that you must meet to qualify.

When looking at your resources, Medicare will count money in the bank (either checking or savings), as well as any stocks and bonds you hold.

What won’t count against you is home ownership and the value of your home; ownership of one vehicle; having a burial plot; having up to $1,500 saved for burial expenses; furniture; and any other household and personal items. None of those things will automatically disqualify you from any of the programs listed below.

So without further ado, here are four Medicare savings programs you might not know about…

Qualified Medicare Beneficiary (QMB) Program

What it offers: Helping paying for both Part A and Part B premiums, plus deductibles, coinsurance and copayments

Income limitations:

Individual monthly income limit* Married couple monthly income limit* Individual resource limit Married couple resource limit
$1,032 $1,392 $7,560 $11,340

* Note: Limitations are slightly higher in Alaska and Hawaii.

If you qualify for the QMB program, Medicare providers legally aren’t allowed to bill you for Medicare deductibles, coinsurance or copays. (You will, however, have to pay up to $3.70 in 2018 for prescription drugs under Medicare Part D at your pharmacy.)

But that doesn’t mean some providers won’t try to stick you with a bill you shouldn’t owe! If the provider doesn’t reverse the charge when you tell them about the law, Medicare advises QMB recipients to call 1-800-MEDICARE (1-800-633-4227) for help resolving the billing issue.

Specified Low-Income Medicare Beneficiary (SLMB) Program

What it offers: Helping paying for Part B premiums, such as doctor’s appointments and outpatient visits

Income limitations:

Individual monthly income limit* Married couple monthly income limit* Individual resource limit Married couple resource limit
$1,234 $1,666 $7,560 $11,340

Eligibility for the SLMB Program is twofold, according to this briefing from the Centers for Medicare & Medicaid Services.

First, you must also be eligible for Medicare Part A to be considered for SLMB. Second, your monthly income must fall between 100% and 120% of the annual federal poverty level — plus an additional $20, which is the amount of the monthly SSI income disregard.

Qualifying Individual (QI) Program

What it offers: Helping paying for Part B premiums

Income limitations:

Individual monthly income limit* Married couple monthly income limit* Individual resource limit Married couple resource limit
$1,386 $1,872 $7,560 $11,340

With QI benefits, you must apply each year anew, and the help this program offers is available on a first-come, first-served basis. Contact the regional office of your state’s Centers for Medicare & Medicaid Services to apply.

Being on Medicaid will disqualify you from receiving QI benefits. In granting QI benefits, priority is given to people who received QI benefits the prior year.

Qualified Disabled and Working Individuals (QDWI) Program

What it offers: Helping paying for Part A premiums, such as in-patient hospital stays

Income limits:

Individual monthly income limit* Married couple monthly income limit Individual resource limit Married couple resource limit
$4,132 $5,572 $4,000 $6,000

To qualify for the QDWI program, you must meet at least one of the following criteria:

  • Be a working disabled person under 65
  • Have lost your premium-free Part A upon returning to work
  • Not be receiving medical assistance from your state
  • Come in at or below your state’s income and resource limits

How do you apply for these Medicare savings programs?

Get in touch with your regional office — find yours here. Medicare encourages people to apply even if their income and resources are higher than the figures listed above.

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