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Medicare Savings Program

Sudhir Mathuria

Sudhir Mathuria HEALTHLIFE 360 713-771-2900

You can get help from your state paying your Medicare premiums. In some cases, Medicare Savings Programs may also pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), deductibles, coinsurance, and copayments if you meet certain conditions.

Four kinds of Medicare
Savings Programs

If you have income from work, you may qualify for one of these 4 programs. They are Medicaid programs.
1) Qualified Medicare Beneficiary (QMB) Program QMB income & resource limits in 2018:
Individual monthly income limit $1,032. Married couple monthly income limit $1,392
Individual resource limit $7,560. Married couple resource limit $11,340
Program helps pay for: Part A premiums, Part B premiums, Deductibles, coinsurance, and copayments
Medicare providers aren’t allowed to bill you for Medicare deductibles, coinsurance, and copayments when you get services and items Medicare covers, except outpatient prescription drugs. Pharmacists may charge you up to a limited amount for prescription drugs covered by Medicare Part D.
To make sure your provider knows you have QMB, show both your Medicare and Medicaid or QMB card each time you get care. If you get a bill for medical care Medicare covers, call your provider or plan about the charges. Tell them that you have QMB and can’t be charged for Medicare deductibles, coinsurance and copayments. If this doesn’t resolve the billing problem, call us at 1-800-MEDICARE (1-800-633-4227).
2) Specified Low-Income Medicare Beneficiary (SLMB) Program
SLMB income & resource limits in 2018: Individual monthly income limit $1,234 Married couple monthly income limit $1,666
Individual resource limit $7,560 Married couple resource limit $11,340 Program helps pay for: Part B premiums only
3) Qualifying Individual (QI) Program
You must apply every year for QI benefits. QI applications are granted on a first-come, first-served basis, with priority given to people who got QI benefits the previous year. (You can’t get QI benefits if you qualify for Medicaid).
• QI income & resource limits in 2018:
Individual monthly income limit $1,386.. Married couple monthly income limit $1,872
• Individual resource limit $7,560. Married couple resource limit $11,340 Program helps pay for: Part B premiums only
4) Qualified Disabled and Working Individuals (QDWI) Program The QDWI program helps pay the Part A premium. You may qualify if any of these apply to you: 1) You’re a working disabled person under 65. 2)You lost your premium-free Part A when you went back to work 3)You aren’t getting medical assistance from your state 4)You meet the income and resource limits required by your state QDWI income & resource limits in 2018: Individual monthly income limit $4,132. Married couple monthly income limit $5,572 Individual resource limit $4,000. Married couple resource limit $6,000 Program helps pay for: Part A premiums only
If you qualify for a QMB, SLMB, or QI program, you automatically qualify to get Extra Help paying for Medicare prescription drug coverage. What items are included in the Medicare Savings Program resource limits?
Countable resources include: Money in a checking or savings account, Stocks, Bonds. Countable resources don’t include: Your home, One car, Burial plot up to $1,500 for burial expenses if you have put that money aside, Furniture, Other household and personal items
How do I apply for Medicare Savings Programs?
If you answer yes to these 3 questions, call Texas State Medicaid Program to see you qualify for a Medicare Savings Program.
1. Do you have, or are you eligible for, Part A?
2. Is your income for 2018 at, or below, the income limits above?
3. Do you have limited resources, below the limits above?
It’s important to call or fill out an application if you think you could qualify for savings—even if your income or resources are higher than the amounts listed here.
For suitable Medicare Advantage, Medicare Supplement and Medicare Prescription Drug plan enrollment contact Sudhir Mathuria at 713-771-2900.


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