Qualified Medicare Beneficiary (QMB) - Savings Plan

By: Lewis Mark
Published: Thursday, January 24 2019
Last Updated: 3 years ago

The Qualified Medicare Beneficiary program is just one of four Medicare Savings Programs, or Medicare Savings Plans (MSP). These programs were established by Medicare, with the purpose of helping low-income Medicare beneficiaries pay for their Part A and Part B premiums. Along with premiums, other out-of-pocket costs are partially or fully covered as well.

To define this in simpler terms, an individual who is a Qualified Medicare Beneficiary means that the government must cover certain healthcare costs, such as premiums, deductibles, and copays. The overall goal of this program is to lower the cost of medications and copays for hospitals, doctors and medical procedures.

What Is A Qualified Medicare Beneficiary (QMB) Enrollee?

In order to qualify for assistance, you must have Medicare Part A and meet some income and asset guidelines. If you aren’t enrolled in Part A, but you meet the deadlines, the state where you live will permit you to enroll in both Medicare Part A and the QMB programs.

When it comes to the guidelines of income and assets, every state has different rules and time frames you must adhere to. Though most of the states allow you to enroll at any time of the year, there are some states that have set a specific time during which you can sign up.

Costs That Are Covered

If you are currently enrolled in the program, or will be soon, you likely won’t be responsible for the following out-of-pocket expenses:

  • Medicare cost-sharing
  • Deductibles
  • Coinsurance
  • Copays

Here’s Who Is Eligible

When it comes to who will be considered for the Qualified Medicare Beneficiary program, not everyone will be eligible. So, before you begin your application process, make sure you meet at least some, if not all of the following criteria.

Here is some important, yet crucial information for individuals who are eligible for Part A, but not yet enrolled. You may be able to enroll in Part A at any time throughout the year if you meet certain conditions, and only after you are enrolled can you qualify for the QMB program.

Following are the resources that are counted when the eligibility of an individual is being determined:

  • Savings accounts of the person
  • Checking accounts of the person
  • Stocks that person owns
  • Bonds that person owns
  • Individual Retirement Accounts (IRA’s) of the person
  • Mutual funds of the person

While the following resources are not counted when the eligibility of an individual is being determined:

  • Housing
  • Car owner
  • Burial Plots
  • Personal items
  • Household items
  • Home furniture
  • Burial expenses (given the person has set aside up to $1500)

Income Limits For 2019

In order for you to qualify for the program, your QMB income limits, or QMB reimbursement must be meet the following requirements. It should be noted here that the following QMB income limits or QMB reimbursements are the federal limit for 48 states. The limits for Alaska and Hawaii are higher. There are some states which apply more liberal income and eligibility criteria.

  • For a single person, the monthly income must not exceed $1,032.
  • For a couple, the monthly income must not exceed $1,392.
  • The resources of a single person must not exceed $7,560.
  • The resources of a couple must not exceed $11,340.

Is QMB Same As Medicaid?

In a way, yes. QMB is a benefit of Medicaid that helps low-income Medicare beneficiaries. Since we know that Medicaid supports low-income families and individuals by covering costs that are associated with both long-term custodial care and medical for those individuals who qualify.

Learn More With FirstQuote Medicare

If you’re looking for more information on your eligibility as a Qualified Medicare Beneficiary enrollee, then you may want to visit the official Medicare website. However, if you don’t feel you qualify, and are looking to save money on your out-of-pocket expenses, FirstQuote Medicare can help. Compare Medicare Supplement health insurance quotes with ease by entering your zip code. Learn what plans are available in your area, and start saving today.