There are three main programs, each with different benefits and eligibility requirements.*
- Qualified Medicare Beneficiary (QMB): Pays for Medicare Parts A and B premiums. If you have QMB, typically you should not be billed for Medicare-covered services when seeing Medicare providers or providers in your Medicare Advantage Plan’s network.
- Specified Low-income Medicare Beneficiary (SLMB): Pays for Medicare Part B premium.
- Qualifying Individual (QI) Program: Pays for Medicare Part B premium.
If you enroll in an MSP, you will also automatically get Extra Help, the federal program that helps pay your Medicare prescription drug (Part D) plan costs.
- Calling Social Security Administration can help to qualify a Medicare eligible person for the Extra Help program: 1-800-772-1213.
To qualify for an MSP, you must have Medicare Part A and meet income and asset guidelines (
note that these guidelines vary by state, and some states do not count assets when determining MSP eligibility).
If you do not have Part A but meet QMB eligibility guidelines, your state may have a process to allow you to enroll in Part A and QMB.
- Many states allow this throughout the year, but others limit when you can enroll in Part A.
- Calling Medicaid can help qualifying a Medicare eligible person for the MSP program: 800-541-2831 (for NY State / Onondaga County area 315-435-2928).
Remember, states use different rules to count your income and assets to determine if you are eligible for an MSP.
- Examples of income include wages and Social Security benefits you receive.
- Examples of assets include checking accounts and stocks.
- Certain income and assets may not count when determining your MSP eligibility.
- And some states do not have an asset limit.
If your income or assets seem to be above the MSP guidelines, you should still apply if you need the help.
Source: article taken from Medicare Interactive newsletter