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How to get help with your Medicare costs

Finance & Planning | Jun 23, 2016



There are a lot of costs associated with Medicare, and getting those bills paid can be very stressful. If you are having trouble affording some of your Medicare costs, there are a few programs offered by the Centers for Medicare & Medicaid Services that may be able to help. Each program has different eligibility requirements regarding a beneficiary's monthly income and total assets. Additionally, each one helps cover different costs.

1. Specified Low-Income Medicare Beneficiary Program

The SLMB program exclusively helps beneficiaries cover the costs of their Part B premiums. Here are the eligibility requirements:

  • Married couple monthly income limit: $1,622
  • Individual monthly income limit: $1,208
  • Married couple asset limit: $10,930
  • Individual asset limit: $7,280

2. Qualifying Individual Program

The QI program also covers Part B premiums only and must be reapplied for every year. If you qualify for Medicaid, you are not eligible for this program. Here are the additional requirements:

  • Married couple monthly income limit: $1,823
  • Individual monthly income limit: $1,357
  • Married couple asset limit: $10,930
  • Individual asset limit: $7,280

"You should apply for the QMB program even if you think you don't meet the requirements."

3. Qualified Medicare Beneficiary Program

This program is meant for those with very low incomes, and will help cover Part A premiums, Part B premiums as well as coinsurance, copayments and deductibles. The requirements are as follows:

  • Married couple monthly income limit: $1,355
  • Individual monthly income limit: $1,010
  • Married couple asset limit: $10,930
  • Individual asset limit: $7,280

When it comes to this program in particular, legal advisory website NOLO encouraged beneficiaries to apply even if they do not meet the eligibility requirements. CMS does not take a large portion of your income into account, and in some instances, you may even still be eligible if your income is double the established limit.

4. Qualified Disabled and Working Individuals Program

This program focuses exclusively on helping beneficiaries pay their Part A premiums. In addition to income and asset limits, those who qualify must satisfy the following conditions:

  • They are working, disabled and under 65.
  • They are not receiving medical assistance from their state.
  • They lost their free version of Part A when they returned to work.

Here are the income and asset limits:

  • Married couple monthly income limit: $5,425
  • Individual monthly income limit: $4,045
  • Married couple asset limit: $6,000
  • Individual asset limit: $4,000

Important information to know

When it comes to assets, it is important to understand what CMS does and does not consider. All stocks, bonds and money in checking and savings accounts are counted toward a beneficiary's assets, but a home, car, burial plot, furniture and other household items do not count. In addition, beneficiaries are allowed to set aside up to $1,500 in burial expenses that will not be counted toward their assets.

The income and asset limits tend to fluctuate, so make sure to check the CMS website every year to see if anything has changed. In addition, if you are located in Alaska and Hawaii, your limits will be a little bit higher. If you live in one of those two states or are still unsure if you are eligible for a program, contact Medicare to find out whether you qualify for assistance.